Nothing Turns Out The Way Its Supposed To
by DarkAndTwistyGrey
Summary: AU MerDer. Meredith Grey did not tell anyone about her medical condition, she finally managed to leave her past behind. None of the staff of Seattle Grace Hospital knows about her secret and she does not intend on ever telling somebody. Not even her immediate *family* ... But as far life goes, plans never work out the way they are supposed to ... [MerDer / MerCris centric]
1. Prologue

**Prologue**

* * *

**The game. They say a person either has what it takes to play, or they don't. My mother was one of the greats. Me on the other hand... I'm kinda screwed. Like I said I'm screwed. I can't think of any one reason why I want to be a surgeon. But I can think of a thousand reasons why I should quit. They make it hard on purpose. There are lives in our hands. There comes a moment when it's more than just a game. And you either take that step forward or turn around and walk away. I could quit, but here's the thing... I love the playing field. **Meredith Grey; A Hard Day´s Night

* * *

_I hadn't told anyone. I haven't even told my person. Not even Cristina, even though she's my person. I thought about telling her, I really did but it scares me when other people know. I don't like other people know about it. I don't like to talk about it. It. The big secret. There are things that can't be changed at all. At all. Sadly, unfortunately it was and nothing would be able to change it. Ever. And this was one of those things. And actually, it bothers me not at all. At least it had never bothered me before. Had. Now it does.  
_

_I didn't care about people talking behind someone's back. They don't have clue what it's like to be born with a heart defect and everything else. They don't know what it is like to live with it. To live with a organic heart defect that was congenital. Meaning, it occurs right after birth or in the weeks after birth. But some ccongenital defects are detected too late. These babies die when the PDA closes. It is a death sentence for them without the surgery - and it almost was a death sentence for me too. These other people ... They think heart disease it that what old people get. They see arteriosclerosis and heart attacks and heart failure. But there is another field that deals with cardiology in children. Babies. Adolescents who are heart patients since birth. O__nce heart kid, always heart kid, it's what they say in Germany.* They do not know anything how life is for children, adolescents and adults who have been born with a heart defect. Most of them never had anything that required immediate medical Attention right after birth._

_But now? It's different. Totally different. Everything is different now. I am an adult now, and I have spot as a surgical intern at Seattle Grace Hospital and saving other people's life's- that's known to take a great deal of time. And I'm not sure whether I should tell someone ... Like Dr. Miranda Bailey, our stiff but caring resident. We couldn't have gotten a better resident. All the others are morons. Sorry for saying that but it's true. Dr. Richard Webber, the chief of Seattle Grace, he and my mother We - that are Cristina, who is my person by the way, Izzie also known as barbie, George also called 007 after he froze in surgery when he ruptered the caecum when he did the first appendectomy. They always choose a resident each year that then can perform this simple procedure. It's sort of a tradition. But back to the point. I swore I wouldn't tell anyone. Nobody knows about it. Nobody, they are all totally clueless about my heart malformation. Even my resident, Dr. Miranda Bailey, doesn't know. The Chief doesn't know. Also there's the fact that I haven't gone to cardiac follow - ups since three years, which is irresponsible and dangerous, oh and not mention the word risky. Because it is risky, especially for me if something happens.**  
**_

_It is very risky not to know that. If something happens and nobody has a freaking clue what is going on with you they´ll lose important time which can decide whether you'll survive or not. A simple decision can decide whether you live or die. It can be a matter of live and death But that is just worst case scenario ... But even the worst case scenario can happen, can become true which I don't hope.  
_

_Like I said, nobody has a clue about my medical condition. __Even if it's risky. For me. That nobody knows is risky, I do know that. I am a doctor after all, but if I tell them about what is going on, they'll look at me like a patient. But here's the thing: I hate being the patient. And on top of that, the rumours. The nurses and all the other staff at Seattle Grace Hospital like to gossip. And I don't like when people talk about me. I have had then when Derek went back to Addison and I was like ... Fact is, I don't like it when people talk about me. __"Have you heard? Ellis Grey's daughter is living with a heart defect." "Wow, how can she be a doctor if she#s living with such a condition?" "What do you think, is it a simple defect or was it life - threathening?" They will talk about me if they find out. Then I'll be number one gossip topic in the Hospital. It's not like you can hide anything from these nurses. They'll gossip, no matter what. Even if you tell them to stop, they will still do it.  
_

_**And I don't want that.** Which is understandable considering the whole situation. So nobody of the staff at Seattle Grace Hospital knows ... Not even the Chief and my resident. It is reckless. I know. But it's my choice. It is my reckless choice. Nobody knows. And I really hope it stays that way. George and Izzie don't have a single clue about me being born with congenital heart disease. __I keep__ the medications I need to take 'cause of my heart condition in my room so they do not see _them and start asking me why I take them. It is none of their business. That is one of the reasons I don´t keep them in the bathroom where everybody can see what the other one has lying around there. If I would do that they would know. They are doctor's, they know what medication you can get over the counter and the ones you need a prescription to get them. And when they see the name or ___active pharmaceutical ingredient (API) they will know what it going on. I mean they know what diuretics and digitalis are and what they are used for._

_But George and Izzie don't know. Cristina doesn't know. Derek is clueless as well. Nobody know about anything. Just me. Me, my mother and nobody else. I think it is the best solution. But I know, it will come out someday. The truth will always come out and when it does, it is usually shocking. Yes, having a colleague with a CHD and not knowing about it is shocking.  
_

_And my mother. Ellis Grey. She knew. Of course she did. She was there when I was diagnosed with my heart condition. I don't remember very much from my years as a kid, I don't remember everything clearly from the third time they operated on me. It is only bits and pieces that I remember. Except for the things that happened when I was older. Some things I only know because she told me. They wanted wait with the second surgery until at least maybe six months. But then I have suffered pulmonary edema and the surgeons went forth with the surgery, waiting was no longer optional. They had to go in to prevent Eisenmenger's reaction and pulmonary hypertension due to my complete Atrioventricular Septal Defect. It can lead to pulmonary edema and if you wait to long before doing the surgery it may be too late for a repair. Normally, you repair a complete AVSD at three to six months, one year tops. With a partial one you can wait until the child is stronger ... _

_So back to my mother. She knows. Or now knew. Well, now she has forgotten, she has advanced Alzheimer's, and lives in a nursing home at the end of the city. Nonody knows about her suffering from advanced, early - onset Alzheimer's as well. She made me swear I would never tell anyone. But I did, I told Derek but he is the only one who knows. No one knows about my medical condition. And I hope it stays that way. But unfortunately nobody has influence about secrets being told or staying in the dark. And the truth comes always out. Sooner rather than later. Usually it is shocking. Very shocking.  
_

_Then there's Derek. Derek Shepherd. Big - shot neurosurgeon, world - renowned neurosurgeon from New York City, Mount Sinai, East Coast. McDreamy, as jokingly Cristina calls him when we talk about him. We call it freak out time and Cristina always kicks him out of bed which happens quite often. Unfortunately for him. But he deals with it and he know I need my freak out time with Cristina. But he is the love of my live. He is my McDreamy. But first, he was married when we met at Joe´s Bar and didn´t even tell me until she showed up in the Hospital Lobby. That so wasn´t the greatest memory. His wife also works at Seattle Grace after they tried to save their already broken marriage but they failed. So, no one knows about it. About the secret, I mean. Hopefully it will remain a secret, 'cause some things are better off if they stay in the dark._

* * *

Meredith sighed. She had a day off, that was an absolute rarity. Especially as an intern. But she bothered something: her past. There were mostly unpleasant memories- surgeries, doctors appointments, heart catheter studies ... And once a electrophysiological study, 'cause she's been having arrhythmias. But then Meredith had managed to leave her past finally behind.

She went to Europe for three months with her friend, Sadie and then she decided to go to med school and after years of studying she graduated best in her class. She lost contact with Sadie after being accepted at Dartmouth, they haven´t heard from each other since then. And Meredith did not care. Now she had Cristina. Her twisted sister, the sister she never had ...

She had never given up on her dream. Her dream was to become a great surgeon. Like her mother. She employed to follow in the very, very big footsteps of the legendary and famed Ellis Grey, who was the first female surgeon and invented the ´Grey Method´. She also won the Harper Avery Price twice. It was the greatest Award any medical professional could win and it was sponsored by the Harper Avery Foundation.

Every med student knows her name.

And Meredith wanted to be a doctor too- since she got her first suture kit for her birthday. But first it didn´t look like she could realize this dream.

But then, everything worked out for good.

* * *

**Flashback: Meredith, 5 years**

_It beeps rhythmically. It was the cardiac monitor she was connected to. It was registering her heartbeat. Something was blinking. Everything seemed cold and sterile. Five year old Meredith didn't know where she was. Confused, she tried to move. With difficulty, she turned her head to the side, saw a screen with such funny sequences on it, also this machine beeped all the time. She raised her head. At least she tried to to do that, but something stopped her- She breathed in deeply. She was confused and didn't know where she was or why she was here. She had no single idea why she could be here. Anyway, this beeping is really annoying. And everything was somehow blurry. As if the room was spinning. There were too much wires and she had central line in her. And then there were those electrodes and ECG leads. She always had hated this procedure when she had the check up with her pediatric cardiologist.  
_

_In addition, alone this movement was exhausting, so she let herself fall back into the pillow. She tried to force air into her lungs, but it wasn't easy. Again she tried. It was definitely hard to breathe. Something bad was going on, something was terribly wrong. Again this question? Why was she here. She didn't know. Meredith swallowed, her throat was dry, and besides that, she had no idea where the hell she was. Meredith raised her hand, she saw a cannulae. She knew how these things were called, through them the patients in hospital could get medicine. _

_In that moment she knew where she was. The hospital. She was in the hospital. But why? Why was she here? Lastly, her status deteriorated and Ellis made go see a doctor. Now they were at the Hospital because of it. But why were there all those devices that made all that noise? She hated that beeping and bllinking. She's got a headache from it. It's supposed to stop. She didn't know that all these devices were important for monitoring her well - being. To monitor her vital functions like heartbeat, heart rhythm, pulse, oxygenation et cetera.  
_

_"Hey." Meredith croaked helplessly. No one heard her. Again she tried to make a sound to get someone's attention. This time she was successful, a doctor who was standing a few feet away from her heard her. He came up to her and said, surprised: "Nurse, page Dr. Grey, her daughter just woke up." He called for a nurse who was standing nearby at the nurses station. Meredith closed her eyes, she was tired. Vaguely she could hear the doctor talking to someone in the room. "Meredith?" The little girl blinked her eyes closed again. Trembling, she took a deep breath. Suddenly her heart rate accelerated. Meredith's heart rate sped up uncontrollably and she had trouble breathing because of that. She had no control over anything. The whole room was spinning. Her heart was beating rapidly and she felt her breathing quicken. She had difficulty breathing. She panicked, everything was a blur. Meredith gasped desperately trying to get enough oxygen into her lungs, but failed. _

_The doctor who had spoken to her, saw her struggling and analyzed the situation within seconds and pressed a button on the wall. It was the red code button. He was calling for help. Then it creaked in the wires and some weird sounds were coming, then it worked. The intercom awakened to life. The doctor meanwhile grabbed a respiratory mask to get her oxygenation stabilized but it didn't work. Meredith's pulse oxygen was still falling and her pulse oxymeter was still whining because of the lack of oxygen-  
_

_"Code Blue, paediatric ICU. I repeat, Code Blue, paediatric ICU." _

_A computer voice over intercom said. "Help." Meredith managed to say out, her voice breaking. "Breathe okay? Calm down, breathe, it will be better soon." The doctor tried to calm her, but Meredith didn't seem to hear anything. Her coloring changed to blue. She became cyanotic. She had a hypoxic seizure. Lack of oxygen. Central cyanosis caused by her heart. But the worst was shortness of breath and the feeling her heart would jump right out of her chest. More doctors and nurses rushed to her room and started working on her to get her stabilized. "Get a Crash cart in case she starts coding." One doctor said, everything moved. She felt a sudden wave of dizziness overcome her. Then, everything went black. Meredith passed out... __"Damn it, she´s lost consciousness. We have to figure out what's causing this." The pediatric heart surgeon said and looked at her oxygen saturation and blood pressure._

* * *

**A/N: _So, that is my first real try on a multichapter fic in another language. _**

**_I am excited!_**

**_Sorry, if there are any grammar mistakes or mistakes in my spelling. My absolute OTP is Meredith and Derek. I love them, my obsession to them is already kind of embarrassing. I am also a big supporter of the Mertina friendship. The twisted sisters are just great together. You'll see them together a lot... And I have this somewhat weird obsession with pediatric cardiology, just like Cristina is addicted to cardiology too. I kind of can relate to that... I know I am rambling, so... _**

**_Now we come to the medical things: P_**_**ulmonary hypertension (PH) is an increase of blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, leg swelling and other symptoms. Pulmonary hypertension can be a severe disease with a markedly decreased exercise tolerance and heart failure. **_**_Eisenmenger's reaction (short ES, or tardive cyanosis) is defined as the process in which a left to right shunt caused by a congenital heart defect in the fetal heart causes increased flow through the pulmonary vasculature, causing pulmonary Hypertension, which in turn causes increased pressures in the right side of the heart and reversal of the shunt into a right-to-left shunt._**

**_I hope you'll like it. _**

**_And hopefully leave a review._**

**_P.S.:_ Once heart kid, always heart kid is what they say in Germany. The original phrase is 'Einmal Herzkind, immer Herzkind' and means that children who are born with a heart defect always are at risk for a setback. Hell, even arrhythmias can occur twenty - fourty years after the surgery. Time doesn't matter, there is no guarantee for anything. Even the the cardiologist says, it's highly unlikely something will happen, it still can.  
**


	2. Chapter 2

**Chapter 2**

* * *

**Any first year med student knows that an increase heart rate is a sign of trouble. A racing heart can indicate anything from a panic disorder to something much, much more serious. A heart that flutters, or one that skips a beat, could be a sign of secret affliction or it could indicate romance which is the biggest trouble of all. It seems we have no control what so ever over our own hearts. Condition can change without warning. Romance can make the heart pound just like panic can. And panic can make it stop cold in your chest. It's no wonder doctors spend so much time to keep the heart stable, to keep it slow, steady, regular to stop the heart from pounding out of your chest from the dread of something terrible or the anticipation of something else entirely. **Meredith Grey; Beat Your Heart Out

* * *

Unsure of what to do, Meredith opened her mother's closet with all the medical things she had lying around in there. A big, blue chart was it that has catched her eye. Her name was on it and it seemed like something really important. Meredith reached for a chart that she had found in a closet, it was extremely heavy. The file was heavy. Her name was on it. It was a patient chart. Why was her name on the chart? Meredith did not know, but assumed it had something to do with her being born with a serious heart defect. Her gaze slid to her scar. It was about six inches long and it was not a thin line. The scar is clearly visible. Meredith knew, without surgery she would have been dead, but still, the scar is very noticeable. But a total median sternotomy will do that to you. Meredith sighed and traced with her fingers the chart. She questioned herself whether she should open it or not. Maybe it would be better if she did not open the file. She was scared of what she might find in there- or what she might not find in there. For sure, she would find her birth certificate in there, along with other medical stuff that was somehow related to her medical status.

Back to the *horrible* scar on her chest, midline. She never liked swimming because of it, because then everyone would see it, maybe point and stare or worse, talk. But if you wanna live, sometimes you need to make sacrifices for it. And a scar was totally okay in order to get a shot at living. That Derek hadn´t noticed is a miracle. He had seen her naked before. Meredith slowly opened the chart and gasped. There were ultrasound images, letters from her pediatric cardiologist, pediatrician and her surgeons that performed the surgeries, lab results - why did Ellis have her lab results - she wondered where she got that all. Probably she harassed her doctors until she got all the information she needed to cover all bases. That sounded exactly like Ellis Grey, it was typical Ellis Grey. Meredith chuckled slightly, after all her mother had cared about her. Otherwise she would not have gathered all this information and imaging. Meredith shook her head and looked through it again.

Ellis had been documenting everything that happened. Everything, as in really everything – her surgeries, sonography pictures of her heart soon after she was born and they discovered she was sick as well lab results she had hunted down. Meredith stared at the chart in utter disbelief.

She picked up the first ultrasound image. It was no baby ultrasound image. It was a picture of Meredith's heart at the age of three days, four – chamber view. Her great arteries were clearly in a malposition and both aorta and pulmonary artery were connected to one ventricle and her heart valves were not healthy as well … She had one AV valve instead of one tricuspid valve and mitral valve. Additionally, her aortic arch was interrupted, she saw that when she looked at another ultrasound image. That is how her heart looked like. Meredith swallowed heavily, she let the picture fall to the ground and breathed in and out. For a slight moment she was feeling dizzy, the whole room went fuzzy. God, what the hell is happening to me? Why am I feeling suddenly so, I don't know, as if the world was moving? Why is the room so fuzzy? Meredith's thoughts raced.

Meredith asked herself why this kept happening.

She remembered the feeling. She has had it before but just couldn't place it. She was lucky she was sitting on the ground when the sensation hit her. When the world finally stopped moving she picked up the ultrasound image and continued to stare at it, with wide opened blue eyes she intensely studied every millimeter of this picture that was showing her heart. Her heart. That heart that was now beating in her chest, only with a few differences: She has had surgery to make it possible that she survived longer than just a few months or days or weeks - living with an interrupted aortic arch ain´t easy, not for her, not for anyone. Without surgery she would have died when her patent ductus arteriosus closed and sent her into cardiogenic shock and cardiac decompensation. But she didn't and Meredith Grey was glad about that every day. She was aware that there was no way she could escape her illness and her past but avoiding was working damn well.

"Meredith? I am home, it is me, Derek." A voice came from downstairs and a door slammed. Soon after that she heard footsteps on the stair. Meredith glanced up, startled. Her breathing quickened but she had learned to suppress her emotions.

Derek was home.

He was not supposed to be home by now … He was supposed to be in surgery, clipping or coiling some aneurysm to prevent it from bursting. Meredith quickly put the ultrasound image away and hid it under a medical reference book on her bedside table. But the chart was still lying there, wide open with all the other sonographies. "Meredith." Someone shouted again, Meredith recognized Derek's voice. She looked up, looked at the chart and felt her heart beating faster- out of fear. He could not see her like this or anything of this like this. He would ask what this is and she is afraid of not having an answer for him. So she grabbed the heavy chart, pulled all sonographs et cetera together and quickly stood up, pushed the chart back in the closet, while Derek came up the stairs. Meredith was more than relieved when the chart with her medical information was safely in the back of her closet. He was smiling at her with this gorgeous McDreamy smile.

His blue eyes were fixated on her. Meredith was smiling at him widely, she was sitting on her bed and was waiting for him. Derek loved this girl with every fiber of his body and his heart swelled when he saw her sitting there in her grayish Dartmouth t – shirt she looked sweet in. "You already home?" Meredith asked the neurosurgeon who entered the room. Derek nodded and pulled his sweatshirt over his head, exposing his torso. "I am. In addition to my elective surgeries I had to step in when one of the neuro residents screwed up." He told her.

"But the most interesting surgery was the tumor removal."

"I wish I could have scrubbed in on this one." Meredith let out a deep sigh before looking over to Derek who quickly consoled her by saying: "Hey, Mer. There will be other craniotomies, keyhole craniotomies, sagittal sinus bypasses, the list goes on."

"You're right." Meredith agreed for one with her boyfriend.

"Of course I am right." Derek kissed her and sat next to her on their bed. "You look great." He complimented her. Meredith chuckled lightly. "So do you." "Well, I am McDreamy." "I thought you hated that name." Meredith held against. "I do but sometimes it's better just to go with it." Derek retorted. "Oh, McDreamy likes his McNickname. Who would have thought?" Meredith couldn't help but say out loud. "So, tell me. How was your day? Did you get a good intern?" She wanted to know, already knowing his answer. "Not as good as you. You have great potential." He blurted out, looking serious at her causing Meredith to chuckle. "And you aren't just saying that because I am sleeping with you?" She wanted to know, feigned hurt.

"Oh, no, there is no way I am thinking that. I mean, you know that this with us is more than just an easy flirt or something. It's a relationship, with you and I being together." He said, sounding fake shocked and then he kissed her right on the mouth.

"You once told me I was like coming out for fresh air …" Meredith trailed off.

"I still think of you this way." Derek quickly reassured her.

"Come here." He pulled Meredith into a giant bear hug. He breathed in her scent and felt like he never wanted to let her go. Eventually, he let go and said: "Why don't we go downstairs? I could fix us something to eat. You must be hungry."

In this moment, Meredith's stomach grumbled. "Looks like someone is hungry …" Derek stated. It was not a question. "Hm." Derek got up and walked downstairs. Soon Meredith heard him doing things in her kitchen and she followed him to look what he is doing. She guessed that he was making dinner, very late dinner. After ten minutes, Derek had set the kitchen table and there was salad bowl in the middle. "Dinner is ready." He announced. "You've made healthy salad." Meredith said after one look, a warm and appreciating smile was to be seen on her face. The neurosurgeon nodded. "It's healthy in contrary to your pizza eating habits."

"Fair enough." Meredith replied, a sparkle in her eyes.

After they started eating, Meredith couldn't resist. She picked up a tomato with her fork before asking: "Have you had any interesting cases today?" Meredith asked, wanting to know show interest in his workday. Derek tilted his head, looked at her with his McDreamy look and smiled.

"Yes." He said slowly.

"There was an exciting case." Meredith looked at Derek with glowing eyes. "I wanna hear details." She told him.

"Not now, Mer. We're eating." Derek told her.

"This can wait. We have all the time of the world." He told her. After they both finished their meals and cleaned up the dishes, they went upstairs. However, Derek just smiled and grabbed Meredith's hand and pulled her into his arms. "What is wrong? Did I ..." Meredith asked confused. "Come here." Derek just said. Meredith looked at him, trying to figure out what he wanted to do. _Sex,_ it was a word with three magic letters. But it was not what Derek had in mind.

Hesitantly she followed his directions. Both lay on the bed. For a Moment it was quiet, nobody said anything. Then Meredith could no longer contain herself. She just had to kiss Derek. Derek kissed her too. After a while, Meredith gently pulled away and said. "What about your patient? The surgery you performed today?" Excitement sounded in her voice when she asked him about the surgery. Derek just grinned. She really _was _loving surgery. But he also noted that she is not as excited when it is about other surgeries than neurosurgery. He couldn't help but get the presumption that neurosurgery was her go – to specialty, the one she liked the most right after cardiothoracics. He had seen that she developed a liking in cardio, just as Cristina has. With the only difference that she was more into cardio than Meredith is.

"Oh, yeah, it was a tumor resection and the tumor was located on an extraordinarily difficult location. One slip and the patient would have been dead or paralyzed." Derek began to talk about the surgery. It had been long, tiring and exhausting but in the long run it had been worth it. Meredith listened enviously, she loved being in the OR, especially Derek's OR. She could totally imagine him poking in someone's brain with his ferryboat scrub cap on his head, she could hear him saying: "It's a beautiful day to save lives." Maybe that she had inherited from Ellis, maybe being a good surgeon was somehow genetic. Maybe. Maybe. After he finished, Meredith laughed and kissed Derek again and then they were having wild, mind-blowing sex after a long day to relax themselves.

* * *

**Meredith, 5 years old**

_Five year old Meredith has been admitted to Mercy West Hospital. They were still living in Seattle. Ellis Grey was still working in Seattle Grace Hospital as a resident. But she and Meredith were currently facing difficult times due to Meredith's medical condition. Ellis had noticed that Meredith's cardiac symptoms worsened. She knew Meredith needed a surgical consult with her medical history of two previous heart surgeries with the use of CPB. Now Meredith was in a hospital room, connected to a cardiac monitor and pulse oximeter to check the oxygen saturation that has been a bit low. This was her second day in the hospital. When she was admitted she asked her mother why she was here and what was going on. "There are most certainly problems caused by your heart and since the heart is a vital organ we need to check it." "So when can I go back to daycare?" Meredith asked. "We'll have to see, Sweetie. Let's just wait what the doctor says." Ellis helped Meredith settle in and change into a hospital gown. _

_Meredith had a difficult time breathing. And there was no improvement. The attending physician has tried everything possible so far. But there is no improvement in her condition. Not even slight. None. She got extra over an oxygen mask covering mouth and nose. But her saturations stayed more on the low side. The doctors who were treating her did not like that at all. The doctor said to a nurse: "Get Dr. Ellis Grey. Page her immediately. Now, move. I am also ordering a portable chest x-ray and an ultrasound." "I´m on it, Dr. Greeves.", the nurse quickly replied and left the room to get Ellis Grey and the other requested things. But when they ultrasound wasn't coming soon enough, he had to repeat his order._ _"I need a portable ultrasound, right now." He barked needed to be quick and thorough._

_The monitor started to produce a sharp and rapid tone in that specific moment, and the heart rate on the monitor accelerated instantly, what the hell was going on with Meredith. Meredith's eyes were half closed, her breathing was shallow and accelerated. It was taking up all the strength she had left. "Meredith, are you still with us?" Someone tried to talk to her but Meredith wasn't able to respond. Oxygen Saturation went down to 89%, which was really bad. "Damn it. She is losing consciousness. Prepare for intubation now. Pediatric intubation tray now." After Dr. Greeves got the ET- tube in, her sats went up and stabilized. _

_"Sats are going up. Good. Now, WHERE IS THE DAMNED ULTRASOUND?" He bellowed, they were walking on borrowed time which means they should get their asses moving to help this little, innocent girl who has her whole ahead of her. Finally the nurse came with the portable ultrasound machine. He instantly started with the TTE (transthoracic echocardiography) of the heart and finally he found the cause. Finally they knew what was going on: a narrowing of the right ventricular outflow tract (right ventricular outflow tract obstruction), this anomaly often occurs in children with corrected Taussig- Bing anomaly. _

_"Damn." The doctor muttered distinctly to his colleague from pediatrics who was on this case as well. "We have to open her back up." Meanwhile, Ellis arrived from Seattle Grace. She didn´t tell her colleagues or superior about her daughter´s condition, because it was none of their business. They do not have to know about her being born with a CHD. They would just say that she should stay at home and that she doesn´t belong in the OR, even if they are wrong. And they are. They just did not see her potential as a surgeon. All her superiors and attendings saw was that she was a woman and that a few years ago she would not even have the chance to at least try it. "Do you know now what's wrong with her? Do you have a diagnosis? And why is she intubated?" She asked worried. How could it get so bad in the time she wasn´t here? How did they let it get this bad before finally reacting and taking matters into their own hands to make sure the patient is stable?_

_"Yes, Dr. Grey. Your daughter needs risky open heart surgery. She has a stenosis of the right ventricular outflow tract. I'm sorry. We intubated her, because her pulse ox went down to 89%, which is extremely low." He explained. "Why didn't you do the echo before? Did she develop pulmonary edema? She's on diuretics." Ellis rambled, every bit of information was good. The faint beeping sounds coming from the machines Meredith was connected onto could be heard. Ellis looked at him briefly and then asked, "When? When do you want to go in?" Impatiently she waited for an answer. The surgeon sighed. He exhaled sharply. Ellis was looking at him expectantly and impatiently._

_"We think tomorrow's the best option in her case." The physician quickly explained. Ellis took a deep breath and then sat down on a chair next to her daughter's Hospital bed. It was not easy to be a surgeon and at the same time taking care of a child that also has a heart defect. "But we are gonna make it through all of this crap." She whispered to her sleeping daughter. Of course Meredith did not hear her. She was heavily sedated and intubated so she wouldn't remember any of this. Only the beeping of the monitors could be heard and the whooping of the vent that was breathing for her. The next morning was there way too fast. A herd of doctors and nurses came to take her down to the OR. "It's time. We need to take her up." The doctor said. Ellis looked at her. She did not like this at all but she also knew that this was important for her. She gave her daughter a loving kiss on the forehead but seeing her off to the OR, a place where she was herself but now … not with her daughter being the patient. Her daughter was only five years old and this was the third open heart surgery she had gone through._

_In the next morning they brought her into the OR to correct her right ventricular outflow tract obstruction that causes all these symptoms. The surgery went relatively well, considering everything that happened before. "Dr. Grey?" The lead surgeon came to inform her that Meredith is being taken up to Pediatric Intensive Care Unit to monitor her. "How did it go? How did she respond? What are her vitals? Is she extubated or did you leave the tube in?" She asked questions. "I am here to update you on how Meredith's doing. She is being moved to PICU now. As soon as she's settled in you can see her." "Thank you." Ellis smiled when she heard her daughter was going to be okay._

* * *

The next morning, Meredith woke up early. She didn´t sleep very well. She'd been sleeping very lightly and was tossing around all the night. Derek always says that she snored and she does. But that wasn´t what kept her awake at night, occupying her mind. It was another, much more complicated thing with lots of complexity. Her heart, what else? She still hasn´t told Bailey or Webber about her CHD nor is she going to or planning to do so any time soon. She yawned, then got up and made her way to the bathroom. But before that, she opened her drawer and took out her meds.

She knew the needed dosage and swallowed the pills with water. Derek did not even stir. Meredith looked over his sleeping figure and felt bad that he did not know. Oh, these damn trust issues. After she had taken her daily dose of _Furosemid _and an additional dose of digitalis she put them back into her drawer. But she forgot to put one packing away … when she walked over to the bathroom. Izzie and George were still asleep, and Derek was still lying next her with closed eyes. Meredith had to work today. She kinda hated being on call- and Dr. Bailey doesn´t like when people are too late. But she also liked being on call 'cause that means sometimes that she gets to scrub in on some trauma surgery. She'd seen a Mattox maneuver once which is a trauma move. Meredith leaned for a on the bathroom door few seconds after she accidently dropped a tube of toothpaste. "Dang it." She cursed in a quiet voice. She didn't want to wake her roommates nor Derek who was still sleeping like a baby.

How can he possibly sleep through her snoring? Meredith had no idea. But it was good.

She felt a little dizzy for a few seconds.

Everything in the small room was blurry, fuzzy and somehow moving. Reflexively Meredith leaned at the bathroom door and slowly slid down until she leaned against the tub and closed her eyes for a second while she hoped that the dizziness would disappear soon.

She felt almost her pulse quickening.

Meredith tried to get control of her breathing, maybe this would influence her heart rhythm positively. It probably only was a paroxysmal tachycardia, but you never know. Paroxysmal tachycardia was the medical term for palpitations. She had no idea why this was starting now. She'd been always very strict and accurate with taking her meds.

These tachycardic episodes always happen when you don't need them to happen. Or it could be PVCs. Premature Ventricular Contractions. She breathed deep in, tried to calm down, but her breathing was still intermittently. That could not be true. It wasn't supposed to happen now, her heart should not determine once again her whole life. She just got happy. Her life was great at the moment and now her heart was causing an arrhythmia which is just perfect. Meredith stood up slowly, waiting for her circulation to follow up with her tempo, letting it slowly adapt to change. Finally she was back on her feet, her heart started to beat in a normal sinus rhythm. Yay, a normal sinus rhythm, her heart really should try and keep it like that.

Derek tossed and turned in his and Meredith's bed. Only when he wanted to lay an arm around Meredith he saw the other side of the bed was empty. There was no Meredith. Meredith was not in her bed anymore. Then he heard something. Also, he saw something on her nightstand. He turned and grabbed it. He has never seen this before. It was some kind of medication. It was still half darkened in this room so he couldn't exactly figure out what was standing on the packing. But Derek worried. Why was Meredith taking medication he didn't know of? Maybe she wasn't completely healthy as she claimed to be. He switched on the night lamp and rubbed his eyes. He glanced on the packing he held in his hand. "Furosemid." He read aloud. "That's a diuretic." He said to himself. Why was Meredith taking this kind of medication? He honest to God had no freakin' idea. "Meredith?" Derek asked sleepily, after he woke up and sat upright in bed when he heard a loud crash and then a loud cursing. He looked up. Meredith was the one thing he thought about. His heartbeat accelerated. "Mer?" He called out, his voice near hysteric. He did not know why he was acting so panicky but he just couldn't help the feeling that something might have happened to her.

She could breathe normally again. Meredith slowly inhaled and exhaled. She totally focused on her breathing. After a while everything was back on track. "Meredith?" Derek called out, panic was in his voice when she failed to answer him. Meredith was feeling okay now, the strange feeling something was wrong, slowly disappeared now and she could think clearly. Thank God, if it had not normalized she would have had a huge problem. At best, Derek would have noticed and would have called an ambulance.

"Meredith." He asked louder. No reply. He slowly began to worry. First the mysterious medication and now Meredith wasn't answering. Horror case scenarios ran through his mind and he feared the worst. He couldn't get the image of Amelia out of his head as she overdosed on Oxy. But this was prescribed medication. You are not able to get this in the convenience store. He knew that. Also, he knows what this medication is used for considering he is a doctor and all. It scares the crap out of him. Diuretics are supposed to prevent the build-up of fluid in the body and so stop edemas from occurring. It's used in cardiology. So she either has heart problems or kidney problems since kidney problems can cause an overload of fluids (in the extremities as well as in other parts of the body) as well. But why doesn't he know?

"Meredith." He repeated in panic when he got no response.

Then he heard a loud rumble and Meredith appeared in the doorway, the toothbrush in her hand and looked at him in surprise. "Why are you screaming?" She asked him.

"You´ll wake up Izzie and George. But they need to get their asses out of bed if they want a ride to the hospital." She said. Derek let out a deep breath. Derek smiled in relief. He had really thought something had happened to Mer. Now she was standing there, very much alive and with a toothbrush in her hand. "Okay." She looked at him expectantly. Derek inner debated whether he should ask her about the packing or not. "You forgot this." Derek told her as he handed her the packing. Meredith's breathing quickened and she looked at him panic stricken. "Just breathe." Derek coached her as he rubbed her back to stimulate her lungs. When her breathing has normalized, Meredith looked at him and took the packing from him. "So do you want to tell me what this is about? You're not taking anything illegal, are you?" He asked. "No!" Meredith stared at him in confusion. "I would never take anything if it's not medically necessary." She told him, agitation in her voice. In the other rooms she heard a rumble and a curse. It was Izzie. Izzie was getting up, followed by George who seemed like he was sleepwalking.

"That sounds like they are sleepwalking, Mer." He said, distracted by what he had just seen. Meredith was relieved about it. She did not want to tell him, not now.

"I know." She replied, kissing him softly on his cheek. "This isn't normal. It is only five o'clock in the morning, why don´t you just sleep." He said, yawning. "This is normal, just for the record. I am an intern. We are at the bottom of the surgical food chain and therefore have to do the crap the other don´t want to do." Meredith contradicted as she was suppressing a yawn. This job was very demanding. "With others, you mean ..." Derek trailed off. Meredith nodded. "Residents, attendings like you. Why are doing this?" She asked, wondering although she knew the reason. It was because they should learn, not being harsh to her and her fellow interns would be a disservice. "Because that's how you learn to become a surgeon." Derek explained. "I have to go." She said. She came up to him, gave him a kiss and rushed to the car. Izzie was running down the stairs: "Meredith."

Another time she shouted: "Meredith, wait. We are coming with you." She walked into the kitchen, poured herself coffee to go and George followed her example.

Then they rushed the car, Meredith was already sitting behind the wheel. "Hurry up, or we are going to be late." She put the key in the ignition. The motor roared and George and Izzie came walking through the front door. "We're coming." George replied as he and Izzie sat down in the back of the car. "Where is Mr. McDreamy?" Izzie couldn't help but laugh. "Shut up, he is not working." "Damn and I was hoping to get in on a neuro case." Meredith said sarcastically. Maybe she would work with some other neurosurgeon. There is Weller and Nelson who was called shadow Shepherd. "Neuro is my specialty." Meredith said.

"So you already declared your specialty?" Izzie argued back. "We're first years, Meredith. You should wait till fifth year or something."

"Why don't you stop sticking your nose in other people's concerns?" Meredith said, swallowing the irritated undertone of her voice. She couldn't handle all the perkiness right now.

"Fine but why …"

"Cristina has, she has chosen cardio." Meredith only replied. She was grateful when she was pulling up in the hospital's parking lot. She slid slightly as he tried to park it. She'd hit ice. After a few seconds she had her car back under control. "We're here." She announced grumbly. She opened the driver's door and was met was snowflakes falling from the sky. Her shoes were soaking wet.

She should have been wearing her boots. It was snowing outside. And there was a layer of snow on the ground, partially it was smooth. Thick snowflakes were falling from the sky and Meredith rushed to the car. It was cold and freezing outside.

She made her way to Seattle Grace Hospital, followed by a chatting George and a laughing Izzie.

Meredith walked into the lobby of the Seattle Grace Hospital, and finally entered the elevator, which she reached just in time to hop in because the doors are already closing. Presence of mind she put one foot in between the doors. Meredith and the door opened again. Meredith smiled slightly and got in. In the locker room, she met Alex Karev, who grinned at her. "Hey, Grey, you also on call tonight, are you?"

He asked her. Meredith was not in the mood to talk. She nodded wordlessly, and then pushed past him. Alex came to his locker and turned around. Then he asked, "Is... Are you okay? No offence, but you look a bit pale. I mean I know you people think I am a cold and heartless jerk, but I am not." Meredith answered annoyed: "Of course I'm fine, Evil Spawn. Go and worry about someone else. I don´t need people fussing over me. You get that?" She took a quick sip of water, placed the bottle back and closed her locker. "I know you're not heartless, Alex. Thank you for giving a damn but really, I am okay." Meredith tried her best to assure him.

The moment Dr. Bailey came up to the two. Meredith looked up, totally taken by surprise. She almost dropped her water bottle on the ground.

Bailey acted as she hasn't seen it.

"Come on, rounds in sixteen seconds. Hurry up." She ordered sharply, she was waiting impatiently for her interns. Meredith wondered where Cristina was. She was never late. Too worried she could miss any cool surgeries. After a few minutes the Korean doctor came running and Dr. Bailey said, without turning around: "You are too late, Yang. Rounds already started." "I know. I'm sorry, Bailey.", Cristina quickly apologized. Meredith could not help but laugh, Cristina glared at her. "That's not funny. Bailey will punish me." She hissed at her.

"Whatever you are doing, stop it now. I have absolutely no interest in any of your whatever it is." Dr. Bailey interrupted with an angry voice.

"Grey, Yang, Stop talking." After they finished rounds, Bailey stopped to give them their assignments. "Stevens, you're covering my post-ops and pre-ops, O'Malley is with Torres." "Have fun with replacing knees." Cristina mocked him quietly.

"Shut up." George told her, quietly enough for Bailey not to hear it.

She sighed and finally said resignedly: "Yang, you're on Dr. Burke's service." Cristina looked pleased. Cool heart surgery with Dr. Burke is really something that she stands for. "Grey, you are scrubbing in my cholecystectomy. Take him through pre-op, run his labs etc." Dr. Bailey said slowly and looked around. Grey, schedule Mr. Sadds for his gall bladder removal. "Meredith nodded. "I've got it, Bailey." Meredith hastily replied before taking the chart and walking away. "And what about me?" Alex asked, he was the only one who has not gotten an assignment. Dr. Bailey turned around." Karev? You are with Montgomery." Alex looked at her in disbelief.

"You are joking. I have no desire to act again as vagina squad. I have been on her service since forever. I hate gynie." He complained even if he knows that Bailey won't like this at all. Dr. Bailey looked at him blankly. "Just for that you are with Montgomery the whole week." Alex looked at his superior with disbelief. "Wait, you can´t be serious, Dr. Bailey?" He complained but was immediately cut off by Dr. Bailey who frowned: "Do I look like I'm joking?" Alex shook his head resignedly. He gave up resisting. "No, you don't." "That was a rhetorical question, Karev." Bailey eyed him for a moment. "Then stop whining and go and find Addison Montgomery."

* * *

**Flashback: Meredith, a week old**

_It had now been a week since Meredith Grey was born. At first, everything looked good so far. Her APGAR score had been a bit low, but besides that, everything looked as it should be. The doctors blamed her being born three weeks premature as the cause for the low APGAR score. Nobody ordered any tests to go any further. The doctors were sure Mer had been born healthy which turned out to be huge, undeniable mistake that almost cost her life. Because after three days her patent ductus arteriosus, full name is PDA- fetal connection between aorta and pulmonary artery, closed, that resulted in her declining rapidly. She showed serious symptoms off cardiac distress and went into circulatory collapse because her aorta was interrupted, meaning her body wasn´t getting enough oxygen, because the connection between the pulmonary artery and aorta was missing. Meredith showed early signs of heart failure due to pulmonary flooding. It put additional strain on her heart._

_After a while she was getting cyanotic, but it wasn´t that clear because of the pulmonary recirculation. _

_Her condition deteriorated fast. _

_But first, the physicians really did not respond. But then the doctors, in particular Ellis Grey noticed that she suffered from tachypnea, and besides, she´s had hepatomegaly, Meredith was lethargic and had poor feeding. And when they noticed there were blood pressure differences between her lower extremities and the upper body, the doctors thought for the first time of a congenital heart defect. As soon as they're had her stabilized, they rushed her into surgery.  
_

_Because Meredith showed the symptoms of a severe coarctation of the aorta, the leading physician scheduled an echocardiogram. But what had been discovered while performing the ultrasound was terrifying: Double Outlet Right Ventricle with TGA type and on top of that an interrupted aortic arch type A, where was an interruption of the aortic arch distal to the left. _

_That was a shock for Ellis Grey, Thatcher had been gone by then and now she was all alone ... _

_However, it had missed out in the echocardiography that Meredith had been a complete atrioventricular septal defect (cAVSD) born, which is acyanotic, but is fatal without treatment after 2- 4 years and causes pulmonary hypertension, and in final stages Eisenmenger´s reaction with right left shunt and cyanosis and heart failure... The weeks after the first cardiac procedure weren't easy for the both of them. For the time of her hospital stay, she had a transvenous pacer, the leads will be removed when she gets discharged. It's just a precaution but sometimes even that is necessary._

* * *

Meredith Grey was preparing the patient. When she was finished and the Patient was already anesthetized on the operating table, Dr. Bailey entered the operating room. "Is he under anesthesia?" She asked impatiently. "Yes, he is." The anesthesiologist said. „When do you perform a cholecystectomy?" She asked then. "Severe pain, caused by gallstones or a Cholescystitis. Today the laparoscopic method is used more." Meredith said. Miranda Bailey smiled, a rare phenomenon.

"Passed the test, Grey." Dr. Bailey said with a smile. "Go scrub in, Grey and then get in here." Dr. Bailey instructed her intern. Meredith's eyes lit up as soon as she heard this and she began to scrub in, washing herself sterile. After five minutes, she was ready and entered the operating room. "Grey, come and hold the clamp." Meredith picked up the clamp and she was thrilled to be in the OR, it was a great feeling – the rush, the excitement, the thrill of the cut ... Dr. Bailey did the first cut. Finally Dr. Bailey was able to remove the gallbladder. Meredith watched every move she made with the instruments. Suddenly, Meredith's heartbeat quickened and her breathing became more shallow than usual. Which didn´t go unnoticed by Dr. Bailey. Why did this happen now, Meredith thought to herself. Why? Why now when she was in surgery with her superior?

It wasn´t supposed to happen. It should have never happened.

Her life was pretty normal right now, and it´s supposed to stay that way. But you can't choose what your reality is. Suddenly Dr. Bailey looked up. She noticed something was off with Meredith who wasn´t as nearly as concentrated as she was before. When she finished the stitch, she decided to see what is going on with her intern who had a relatively pale almost white face complexion. She looked at Meredith, as the look of it, seemed to have problems with their breathing. Breathing problems were never good, those were never indicating anything anywhere near good. She frowned and medical instincts kicked in and she was fighting to the urge to drop her instruments and see what's going on. She should page Burke.

"Grey?" She asked when she saw that a light blue shade her face. "Grey? Is everything okay?" She asked. Meredith nodded. "Are you sure?" Dr. Bailey persisted, skeptiscm sounded in her voice.

"Because if I'm not mistaken, this is ..." Dr. Bailey fumbled for words.

She did not quite know what to say, she was unsure. But what she was sure of, here was something going on that was not good. She should talk to her intern who looked yet quite frightened and clearly shocked. Her face told something was going on, that this wasn´t just poor circulation. This was something much more serious. There could be tons of medical explanations for central cyanosis. It could mean heart or lung problems or blood disorders can also have that kind of symptom. However, this meant something bad was going on. Meredith's lips were blue and parts of her face too. Bailey could not look away. She was a doctor. Meredith was a doctor as well. From the look on her face, Bailey guessed that she knew something. This has something to do with cardiology, maybe it was simple to fix, maybe not. They needed Burke, stat.

But would Meredith let her page him? She doubted it, honestly. Meredith would say she was fine. But that's her problem. She is always fine.

Meredith was, as she said herself, always fine.

Always, except today she was wrong. This time she was not fine. She was not anywhere near fine.

"I'm fine." Meredith tried to convince Dr. Bailey.

"I am fine. Really. I am fine. There is no need to worry." She repeated. „Who are you trying to convince, me or you?" Bailey asked. She did not like this situation a little bit. Meredith avoided the question.

"I am fine." Meredith insisted, kept on insisting.

She was fine.

But the many times she said it where clearly showing that she wasn´t. She was not fine. Meredith Grey was not fine. "You should leave and go let your heart get checked because with the cyanosis. I mean, you´re a doctor you know what it could mean. So, please, do me a favor and let me page Dr. Burke to do a cardiac work- up with electrocardiogram, pulse ox and echocardiography where he examines your heart with a wand." She said finally and turned her attention back to the patient.

Meredith looked up in shock. Her world's walls were crashing down around her and there was nothing she could do to stop it.

"Transducer." Meredith corrected without thinking, Bailey gazed at her intern. "So, cyanosis that distinctive is not something to make fun of. What are you going to do? It would be irresponsible if you would not do anything about it." Bailey told her while finishing up their patient. "Cyanosis?" Meredith asked back, her voice tense and shaky. After hearing the word cyanosis, she didn´t listen.

Luckily Dr. Bailey could not see her face expression under the surgical mask.

"Well, your face is turning blue. Shall I page Dr. Burke?" Dr. Bailey asked with a slightly worried expression.

Then she turned her attention back to the patient, who was lying open on the operating table. Meredith had only one thought. She has to get out of here. Immediately. Still, she tried to ignore it and said in a loud voice: "No, it is okay. I am fine." Meredith shook her head vigorously, trying to not show inner panic that was coming up to Dr. Bailey.

But then Meredith shifted uncomfortably, her heart continues to beat irregularly and she just could not do it any longer. "Sorry, Dr. Bailey. I must ..." Meredith managed to say, her hands were shaking a little. She couldn't believe it and did not want to believe it. These PVCs had been a warning sign. Now everything was coming down on her and that fast. She could not do anything about it. "I have to... Take over for me, please." She handed her surgical instruments to her replacement. "Grey, don't leave this OR." She said but the intern did not seem to be listening at all. She seemed to be in a daze, at best. She left the operating room and tore off the surgical mask. Dr. Bailey watched her leave the operating room, then she turned her attention back to the patient on the table. She would deal with it later when she has finished that surgery.

Meredith leaned against the sink in the scrub room and breathed heavily. Cyanosis. This has to be a damned joke, right?

No, not now, Meredith was on the verge of panicking. This was not good. She was experiencing cyanosis, central cyanosis that was caused by her heart – her sick heart that was now about to ruin her life again. Would Derek stay with her if he knew? My life was but just perfect, why did this happen now? Damn it. This could not be happening. I just left an OR because of her heart. Why has it always to be her, damn it? Her thoughts were racing and she knew she should tell them. She should have told them from the beginning, then Bailey wouldn't have looked at her like she was a complete fool for leaving her operating room.

Meredith shook her head in despair. She hated the reality where she was just this girl with the sick heart. That is why she did not tell anyone. She did not want to. She knew it was a hell lot more risky but at least she was being treated without prejudices and benefits and anything.

She was just like the other interns around her. She had been accepted, fully accepted.

And it was great. Now Dr. Bailey would kill her, rip off her head and make her tell them. This was it. All of this would be for nothing. Why am I the one with the sick heart? Why is it me, why does it have to be me? I have nothing done wrong, why? Why? Why? I'd really appreciate some answers. If you have some now would be the perfect time to tell me because I really need some answers. I need some freaking answers. Why is the damned universe so damned screwed up, why. Why. Why. I need some answers. Answers would be very nice. Damn it.

But there was nothing she could do. She left the scrub room. She couldn't face Bailey right now. She just couldn't. So she left, and was now wandering the halls until she met Cristina.

* * *

**_A/N: Thank you for reading this. Hope you´ll leave a review... _**

**_Cyanosis is a physical sign causing bluish discoloration of the skin and mucous membranes. Cyanosis is caused by a lack of oxygen in the blood. Cyanosis is associated with cold temperatures, heart failure, lung diseases, and smothering. It is seen in infants at birth as a result of heart defects, respiratory distress syndrome, or lung and breathing problems._**

**_Premature Ventricular Contractions (PVC), also known as a premature ventricular complex, ventricular premature contraction (or complex or complexes) (VPC), ventricular premature beat (VPB), or ventricular extra systole (VES), is a relatively common event where the heartbeat is initiated by Purkinje fibers in the ventricles rather than by the sinoatrial node, the normal heartbeat initiator. The electrical events of the heart detected by the electrocardiogram allow a PVC to be easily distinguished from a normal heart beat. Although there are many signs and symptoms associated with PVCs, PVCs may have no symptom at all. An isolated PVC is hard to catch without the use of a Holter monitor. PVCs may be perceived as a skipped heartbeat, a strong beat, or a feeling of suction in the chest. They may also cause chest pain, a faint feeling, fatigue, or hyperventilation after exercise. Several PVCs in a row becomes a form of ventricular tachycardia (VT), which is a potentially fatal cardiac arrhythmia. In the setting of existing cardiac disease, however, PVCs must be watched carefully, as they may cause a form of ventricular tachycardia._**

**_Palpitations are an abnormality of heartbeat characterized by simultaneous awareness of one's pulse and discomfort. They can be accompanied by dizziness or difficulty breathing. They might or might not be associated with skipped beats and/or accelerated heart rate._**

**_Cardiogenic shock is a life-threatening medical condition resulting from an inadequate circulation of blood due to primary failure of the ventricles of the heart to function effectively. In infants, it is often caused by PDA dependent congenital heart defects such as Hypoplastic Left Heart Syndrome along other Single Ventricle defects. Because it presents as the child being septic it is difficult to determine whether the child is suffering from a heart defect or some kind of other infection / cause. As HLHS:_**_**In cases of HLHS, the right side of the heart often must pump blood to the body through a patent ductus arteriosus. As the ductus arteriosus usually closes within eleven days after birth, blood flow is severely restricted and eventually cut off, leading to dangerously low circulation and eventually to shock. So it is often late when they discover what they dealing with - differential diagnosis ...**_

**_In medicine, decompensation is the functional deterioration of a previously working structure or system. Decompensation may occur due to fatigue, stress, illness, or old age. When a system is "compensated", it is able to function despite stressors or defects. Decompensation describes an inability to compensate for these deficiencies. It is a general term commonly used in medicine to describe a variety of situations._**

**_Then I´ve mentioned Right Ventricular Outflow Tract Obstruction or short RVOTO. A ventricular outflow tract obstruction is one type of congenital heart defect in which either the right or left ventricular outflow tract is blocked or obstructed. If the left outflow tract is blocked it's called a Left Ventricular Outflow Tract Obstruction also known as LVOTO. In Meredith's condition and type of surgical 'repair' a slight LVOTO could be useful._**


	3. Chapter 3

**Chapter 3**

* * *

**As doctors, we know everybody's secrets. Their medical histories. Sexual histories. Confidential information that is as essential to a surgeon as a ten-blade, and every bit as dangerous. We keep secrets, we have to, but not all secrets can be kept. In some ways, betrayal is inevitable. When our bodies betray us, surgery is often the key to recovery. When we betray each other... When we betray each other, the path to recovery is less clear. We do whatever it takes to rebuild the trust that was lost. And then there are some wounds, some betrayal that are so deep, so profound that there is no way to repair what was lost. And when that happens, there's nothing left to do but wait. **Cristina Yang; From A Whisper To A Scream

* * *

Meredith stood in front of the sink in the scrub room and tried to calm herself down. Through the windows she saw Bailey was continuing the surgery. She was breathing heavily. Her freaking past caught up with her again. Damn it. She did not deserve this. She did not deserve any of this but somehow it was her who has to live with this. Nobody deserved living like this. Meredith wanted to wake up from the current nightmare she was facing. But this, she can't wake up from this because this is the reality, her past has catched up with her, once again threatening to make her life a living hell. She'd been fine the whole way through med school and college. Her heart had been fine. Some people say there is no way of actually knowing that it's fine if they don't do the tests to prove this. But she had a way of feeling whether she was okay or not. And now, right now, she was not. She just left an operating room, fleeing like Bambi from a bushfire. Yet here she was, running along the hallways, passing nurses, doctors and other orderlies just to bump into Cristina.

"Meredith?" Cristina scrunched her nose. She'd never seen Meredith like this before. Meredith was collected and calm in almost every situation, she did not panic easily. But not right now. Right now she was just not herself.

"Wait up." Cristina called.

Something happened, must have happened to send Meredith in this state. Meredith came to a sudden halt. She glanced over to Cristina and walked onwards. Cristina was confused.

"Mer, what are you doing, why are you …"

She followed Meredith, there was no way she would leave her alone like this. Meredith on the other hand tried to get to the basement without anybody seeing her which was senseless 'cause she already had Cristina following her to the basement, because that's where the interns spent the night shifts, when nothing was going on.

"Hey, I'm scrubbing in on a valvular aortic stenosis. That is so impressive. Are you jealous? I, Cristina Yang, am scrubbing in on an open heart surgery. God, I love, love, love cardio. I am addicted to it." She gushed enthusiastically.

Or more like bragging. But that was okay when you consider the fact that she's good at her job just as she is.

Meredith tried to listen to her friend but she couldn't quite focus on the conversation. Her head was occupied with things. "Good that your boyfriend is a cardiac surgeon." Meredith chuckled, allowing herself to think about anything else just not this. And for me too, if I need another surgery on my heart, then he is the one to do it, she thought to herself, adding silently. "Right, it is really ... really ... amazing. God, I am so happy right now. A whole day in the OR, that must be heaven." She said still overly euphoric. But then ... Meredith did not have time to react, even less to say something coherent. She opened her mouth: "That's gre ..." She was cut off by Cristina Yang who stared at her friend with a shocked look on her face. She finally got a grasp on what's going on with her friend. And that was a shock, an unimaginable shock for her. Her blood ran cold as she realized what this means. "Mer …" She whispered hoarsely.

"Cristina, don't. Just don't." Meredith warned her silently.

She stared at her in shock. She couldn't describe it with other words. Meredith did not look very good. She noticed the lack of color in his face, the lack of normal, healthy color. Her face was pale but not only that. It was also cyanotic. But then her eyes fell on Meredith. Her surgery was forgotten instantly. This was way more important.

"Oh for my ever loving God, is that..." Cristina asked shell-shocked.

No, what the heck is happening here? That cannot be true. Meredith is cyanotic. That is a fact. She is looking right at her and this is definitely central cyanosis, the kind of cyanosis caused by congenital heart defects and pulmonary deficits. She knew that since her boyfriend was cardiac surgeon who treats those conditions. She was at her loss of words and that literally did not happen often. But right now it did. Cristina grasped her friend's wrist and held her so that she couldn't get away. Meredith avoided her pressing stare. She knew Cristina would not back down. Not on this, anyway. "That is cyanosis. You are cyanotic, Meredith. Do you have a congenital heart disease? Did you have had open heart surgery? I mean, because that is cyanosis and cyanosis often occurs if you have a CHD or are you ... chronic cyanotic?" Cristina rambled, looking at all possible conclusions and jumping to worst-case scenarios.

Meredith did not answer.

She knew she could tell her and she would be all supportive but she just couldn't bring herself over to do this. There was a chance that Meredith was sick. A real one. And by the looks of her actions she took Bailey nor Webber know about it.

Meredith hasn't replied. She has not said anything ever since the confrontation. "Meredith? Say something, please. Tell me what is going on." Cristina urged suddenly fully alert.

"I'm …" Meredith started.

Cristina looked hopeful but in the end Meredith completed the sentence with: "I'm fine." Typical Mer – avoiding problems until not possible anymore.

"Mer? Is everything all right? Or you have a cardiac problem that I don´t of, because you´ve failed to tell me? I mean, you're turning blue. You are cyanotic. You can't tell me you're not. I know you think you're untouchable but … everyone has problems. We all have them and there is no shame into admitting you have a problem." Meredith couldn't do this, dragging Cristina into her crap, this was not fair to her. She already annoyed her with all her boyfriend-problems.

She was sure she was a burden to everyone she cares for and so she just shuts up about it. She couldn't shake the feeling to feel worthless, another aspect she hated. She wasn't untouchable and they all knew it.

"Cristina, I can't tell you. I'm sorry, but I ..." Meredith stopped abruptly because at the moment Cristinas pager shrieked. Once again, she was saved by an emergency. Cristina shot her a glare, "We're not done talking about this. I am not letting this go. You are my person and I care about you. You can come to me with any problem." She said warmly, it wasn't often that Cristina Yang showed emotions openly. It was Dr. Burke who paged her. The valvular aortic stenosis correction on an eight year old boy, she was supposed to scrub in on this surgery. Due all the worry about her person she totally forgot that she was scrubbing in on Burke's surgery: the pediatric heart patient with the leaking aortic valve.

Speaking of pediatric heart patient, if Meredith had one too, she was a pediatric cardiac patient and an ACHD patient who needs to be seen regularly from a specialist that is specialized on treating adults with congenital heart defects. Her thoughts were racing and she couldn't get them to stop. "You know, I gotta go. Will you tell what's going on with you when you can?" She said after looking at her pager.

"When you are ready to face this. This is not going away Meredith, as much as you want it to but it's not happening."

With that Cristina left.

"Have fun." Meredith called after her retreating back, Cristina didn't even know if Meredith registered the question she has been asking her. Cristina knew nothing of what was going on. How could she possibly know or even imagine what was going on? But eventually she would find out anyway. Meredith sighed as she watched Cristina go. She has to tell her, she is the only one she really trusts and she knows she can rely on her, that she is reliable and trustworthy. She can depend on her. Cristina is her person. And Meredith is Cristina's person. Cristina remembered everything she had seen. Meredith had been blue. Only slightly, but she had been blue. She was cyanotic. Damn, Cristina Yang ranted lost in thought, as she walked through the hospital corridors, knowing anything's wrong with Meredith, who she referred to as her person.

Her only person.

She needs her person to be alive, breathing. She makes her brave. Cyanosis is common symptom in many congenital heart defects. She couldn´t be sick, could she? She is Meredith. And Meredith is always fine. She is fine no matter what ... But what if she wasn't? She is queen of saying everything's fine, even if she's not. Mer did not have a cardiac thing going on.

Or has she?

She absolutely had talk about it with Meredith, because there was definitely something that they do not know. Meredith Grey had a secret. She kept her medical history a secret. 'bout her medical history. For some reason she had not told Cristina. What was weird 'cause she has told her everything about McDreamy and McWife. If only she knew what was going on. She just hoped it was not what they thought it was ... One thing was clear: Meredith should get examined by a doctor. She really should. This could end badly, potentially badly.

But it was bad either way.

Cristina was worried, seriously worried. This was not some kind of boyfriend problem, it was something much more bigger and even more dangerous and dark and probably more difficult to deal with, especially congenital heart defects. But, she did not even know if it was one.

She was leaning against the railing of the catwalk, not seeing Burke coming up to her. He put a hand on her shoulder. Cristina flinched, obviously taken by surprise.

"Is everything on track?" Burke asked, his eyes sparkled as he spoke. But Cristina could barely concentrate. Meredith was occupying her mind. "Yep, of course. Why shouldn't it be?" Cristina finally found her answer after some seconds went by.

Burke's brows furrowed. "You ready for surgery? OR 5, 17:00 PM." He reminded her.

Cristina nodded in reply as she was just lookin' out of the panorama windows, trying to picture this. "I was just … have you seen Meredith today? She was acting weird, and I noticed something. Anyway, it's probably nothing." Cristina relented, not wanting to do this to Mer. It was her person and she was the one to figure it out. "If so, then we have a patient who needs to be taken to pre-op now." Burke ordered her, back into surgeon-mode, superior-mode. Since he was the one in charge of her. He was the attending. "Let's go." He said as he walked over the catwalk, toward the patient room. Cristina was following him only a bit slower so she did not notice him talking to her.

"Dr. Yang?" Dr. Burke's voice brought the young medical assistant back to reality. Cristina snapped out of her thoughts as she and Burke kept on walking through the hospital hallways. "Yes, Dr. Burke. I was distracted." She apologized quickly towards the world-class cardiothoracic surgeon. "So I've noticed." He simply replied, thankfully he did not add anything.

Cristina hinted a smile to express her gratitude and Burke nodded almost imperceptibly.

Then he entered the patient's room, Yang was right behind him. "Hello, Mrs. Lewis, hello Ryan, ready for surgery?" He directed to the mother and the patient he was going to cut open. "Where is your husband?!" Burke asked friendly. "He's downstairs getting coffee for us. He'll be back in a minute." The woman explained. "Yang, present." He said, handing Cristina the patient's medical record. This, the intern opened and took a quick glance at it, skimming over the information and medical history of the boy in question. "Of course, Dr. Burke." Cristina quickly said and started to present the case. "Ryan Lewis, eight years, he was diagnosed with valvular aortic stenosis. He is in for an open heart procedure to repair his hear. We're going to use the cardiopulmonary bypass to bypass the His values are good, the chest X-ray showed no acute progress." Cristina finished presenting the boy´s case.

"Okay ..." the mother began, "What does that mean for us now?" Her voice was uncertain. Dr. Burke looked expectantly toward Cristina and gave her a slight, but noticeable sign that she should continue with explaining. "That means we are operating Ryan today." The mother nodded and stroked her son's hair soothingly.

"Dr. Yang will prepare him for surgery." Dr. Burke gave the command.

"Of course, I will prep this little boy for surgery so that we can get his heart fixed." Cristina gave in, doing the job she was here for and grabbed the medical record.

"I am not little." The boy replied loudly, when he heard Cristina.

"You so are." Cristina laughed. Burke looked at her in disapproval. Cristina noted it and she also saw the boy's features. The boy frowned and looked like he was about to cry, "I am sorry." Cristina apologized. "I did not mean to offend you. But you are a little boy." "I am not." This time Cristina didn´t answer, she had different things playing on her mind, more important things than discussing with a nine or eight year old patient. Burke gave them a smile and said: "Please excuse Dr. Yang and her behavior. I can assure you that this intern is the one you want to have on this case, she might be bold in language but she's skilled. We're going to do our very best work. "Thanks." The mother said and breathed in deeply.

She smiled at the two shortly.

She followed Dr. Burke outside the patient's room and then faced him. He kind of had a serious and attentive look on his expression. "Cristina. Your bedside manner needs work, definitely. Cut the boy some slack, he is about to undergo major open heart surgery." Cristina rolled her eyes but Preston frowned. Cristina sighed and said: "Yes, Dr. Burke, I will work on that." She reassured him that she will really so it. In this moment, a man with two coffee cups was walking toward Ryan's room.

* * *

**Flashback: Meredith, six days**

_Ellis Grey remembered watching the surgeons, who rushed Meredith in the OR. It was totally unreal. When the surgeons were no longer visible, the general surgeon sat in the waiting room for relatives and waited. There were others two, waiting and hugging, some were crying. She never knew how it felt to be the family in the waiting room. And it was horrible. Minutes seem to become hours, hours days and so on. Time seemed to pass slowly. The surgeons just repaired the aorta. The surgeons opened her up through a median sternotomy and then put her on cardiopulmonary bypass machine which is required to take over her heart function, temp regulation and oxygen saturation. _

_After the cannulation of the brachiocephalic trunk they stopped her heart with some kind of medication (pharmalogical cardioplegia) and let the CBM take over for now. But when you are working on the aorta, surgeons usually use a technique where they cool a body down and just perfuse the brain and that´s what they did here too. _

_The leading paediatric heart surgeon on the case just closed the ventricular septal defect trans-tricuspid. But it was a swiss cheese VSD. In the muscular septum was another hole and in the inlet septum too. Meredith's heart was full of holes._ _With continuation of cerebral perfusion the lead surgeon connected the aortic arch end to end and ventral augmented with a patch. Since the aortic arch was hypoplastic; which means it´s too small and underdeveloped; the surgeons performed a procedure called Yasui- operation, which means the cardiac surgeon anastomosed aorta ascendes und pulmonary artery side-to-side and extended it with a 8-mm polytetrafluoroethylene (PTFE) interposition graft from the ascending aorta to the descending aorta. In surgery they also did a pulmonary banding to prevent pulmonary flooding. However, they also discovered another additioning heart defect during surgery: Meredith also had an Atrioventricular Septal Defect (AV Canal Defect / Endocard Cushion Defect)._

_"__Wait." The resident suddenly exclaimed as he noticed something. "What is going on, Orenstein?" "Look, there is a hole in between the two atria." One surgeon said. "What?" the other one exclaimed, he had not noticed that abnormality. He took a look himself and then only confirmed the other one's suspicion. There was another underlying defect here. "Damn it that complicates the whole procedure. What do we do now? Do we continue or do we close her up and only do a palliative procedure and then reopen her when she has gained more weight and is stronger to handle another surgery?" The assisting resident asked as he saw the extent of this, the extent of the defect. This was the important question, the question that determined everything following this. "We close her up and then do a definite repair when she is three months or older." The professional tone of the lead surgeon showed no emotion. He was cold, he has to be._

_"Dr. Grey. We're here to update you on your daughter's condition." The older surgeon said. _

_"Is she out of surgery and in recovery? How are her sats, is she stable or ..." Dr. Grey asked, finally stopped pacing along the floor because she was worried. "First of all, your daughter is stable. We need to see if she makes it through the night. She'll need another surgery in a few months, when she is older and stronger. We have corrected the IAA, but not the Double Outlet left Ventricle. We also discovered ..." The doctor did not say anything straight out. Ellis felt like he was hiding something. She needed to find out what. _

_"What did you discover? There is no need to sugarcoat me." She demanded, her voice breaking slightly but soon she had the control back. I am a doctor, a surgeon. So just tell me straight out." She demanded._

_The surgeon nodded and answered: "In surgery we discovered an abnormal tricuspid and mitral valve. Also, she has an atrial septal defect that needs to be corrected in the next session and an Inlet-VSD. I am sorry." She has not signed consent on correcting the other defects. Ellis stared at the surgeon in utter shock and disbelief._

_"What? You are kidding, right? This is not funny." She scoffed, not wanting this to be real. Ellis didn't want to believe them. How is she going to pull this off? Without help and without a husband? How is she going to do this? Her baby has a condition that probably causes problems throughout her whole life and there was no one to help her. She was all alone. Neither Thatcher nor Richard was here, she thought he was a wuss but still this was his child. And Richard, he'd gone back to Adele or something. "We are serious. I am so sorry that we don´t have better news for you." When the doctors told Ellis Grey about what they did find out while operating on her daughter´s little heart, she just stared at them with disbelief and shock. The world seemed to stop, she knew the freaking odds. She could only picture the kind of life her kid is going to have._

_Nothing made any sense. Nightmare, it was a freaking nightmare. You think you are ´immune´ against something like this, but in the end, there´s no difference between you and the rest of the world. Some surgeons may think that, but it is definitely not true. This was a freaking nightmare for every parent. Meredith was born with a complete Atrioventricular Septal Defect (AVSD / AVCD), an Interrupted aortic arch (IAA), Double Outlet Right Ventricle with TGA-type / sub pulmonic VSD, which means she´s suffering from a Taussig- Bing- Anomaly. Life is not fair. Life is never fair, but sometimes life is really biting you in the ass._

_"Do you want to see your daughter now?" The doctor asked softly. "Yes." She answered and then she followed the doctor to die Neonatal Intensive Care Unit. When she saw her daughter lying there with all these wires and the epimyocardial pacer coming out of her, she tried to show no emotion. She was Ellis Grey, future world-class surgeon and cold. But this 'no emotion' thing ain't so easy. But she held herself together until the doctor left her alone. She looked at heart monitor, her heart was beating regularly. It showed a normal sinus rhythm. She was glad about that. "Meredith." She just said her name as she was holding her little hand. She was still intubated. They'd probably remove in a few days. She always knew that she wanted to name her daughter Meredith. It was such a beautiful name._

_ "Fight, okay? I just need you to fight." She whispered. "Mommy's here."_

_When Meredith was ten days post-op, she started having arrhythmias. JET. Junctional ectopic tachycardia. It often occurs in infants and children who had open heart surgery recently. Postoperative JET usually begins 6-72 hours following cardiopulmonary bypass surgery for repair of congenital heart lesions. It is usually identified during monitoring in the ICU._ _A fall in blood pressure and cardiac output usually occurs concomitantly. _

_Her monitors started beeping loudly as they signaled a fall in blood pressure._

_ In general, postoperative junctional ectopic tachycardia (JET) occurs in the hospital with rapid hemodynamic instability, whereas congenital JET may have a more insidious course before producing signs of congestive heart failure. The doctors also noticed a decreased cardiac output. They suspected she is suffering from one dreaded postoperative complications after correction of congenital heart fault. The rhythm disorder usually occurs 6-72 hours after surgery, and the patient involved is hemodynamically most severely compromised. That was what they suspected Meredith had. Ellis was the first one who noticed the signs and symptoms and called the surgeon who immediately started doing the physical exam and work-up. Maybe the tachycardia developed due to direct Trauma to the AV node, inadequate reaction on reperfusion after removal of the extracorporeal circulation or the anesthetics might have been the cause._

_Patients with congenital JET present with moderate tachycardia and signs of congestive heart failure. Meredith had all these symptoms. Also, a VA dissociation has occurred, which is usually the case, cannon waves may be present in the jugular venous pulse. The intensity of the first heart sound varies when the doctors listened to her chest. Meredith let out a weak sounding cry. That is when she turned blue. Like you know, it was only palliative and not a definite correction. She will need another surgery in a few months. So, Meredith continued to cry and because of the uncoordinated beats of ventricles and atria as well as the tachycardia and increased oxygen consumption rapidly developed cardiac decompensation in Meredith. _

_They took blood from baby Meredith and sent it to the laboratory to get it assessed. They assessed serum magnesium levels, electrolyte levels, and lactate concentration. The surgeons also did a chest film to see if_ _ventricular dilatation and dysfunction there (when signs of pulmonary edema are present) in all patients with JET. Meredith showed signs of pulmonary edema. They also did a repeated echocardiography to significant postoperative residual hemodynamic abnormalities, in rare cases they also do a heart catherization._

_The most important test is in all forms of JET the electrocardiogram. Meredith's ECG showed that the QRS morphology is similar to sinus or atrial-conducted beats. The ventricular rate wasn't equal to the atrial rate which is usually the case in junctional rhythm with 1:1 retrograde VA conduction. An irregular ventricular rate could be observed on her electrocardiogram and that happens when appropriately timed atrial impulses conduct to the ventricles. That means it is a junctional rhythm with retrograde VA dissociation. _

_Also, there was a "warm-up" pattern, usually the arrhythmia starts gradually. An exception to the last 2 patterns described above rarely occurs, when both JET and complete heart block are present. Meredith showed frequences of 300 beats / per minute, that is way too much._

_Soon, Meredith was diagnosed with that life-threatening condition. _

_Without proper treatment in earlier post-operative phases, the mortality is high, also because the normal antiarrhythmics aren´t working ... Since amiodarone is comsidered as the most effective treatment when handling cases with JET (Junctional ectopic tachycardia) , the doctors gave her an i. v. of bolus or a short infusion over 30 to 60 minutes at a dosage. They also treated her pulmonary oedema because the amount of fluid build-up wasn´t causing any good. Well, to Support the drugs, the physicians also decided to try AV sequential pacing therapy treatment, can help to restore AV sequence and cardiac output once the JET rate is reduced. Meredith's heartbeat slowed down after 39 hours. They also treated her with anti-congestive medication like digoxin because of the low cardiac Output and the heart failure._ _When Meredith's condition got better instead of worsening, Ellis was relieved. She knew JET wasn't easy to deal with._

* * *

Meredith, meanwhile, had herself holed up in the basement. Cyanosis. That could not be true. Just now, during her time as an intern – she was royally screwed and of course it was her who was screwed. It's always been her. Why should it change now? She was afraid that the truth will come out. But Meredith knew that at some point everyone would know anyway. "No." she grumbled angrily to herself. Why did it have to start again? Life is not fair. It just will not stop throwing all this crap on her. She was tired of that, so so tired of all this freaking crap. She was now an intern, now isn´t the right time and place of it to start again and making her life a living hell. Why is it always her? Just and only Meredith Grey, magnet for all crap things.

"That cannot be true." She could not believe any of it, that everything went off again. It had to be a nightmare, a frigging nightmare that is going to haunt her Again and Again. Over and Over. This circle would never ever end. Meredith repeated it in a flat, disbelieving tone, ranting: "This cannot be true. I hate it, hate it. This isn't supposed to be like this. It isn't fair. Why is it always, always, always me? God, I don't want it anymore." In the quiet hallways was nobody who could hear her. No human beings were here, only some empty beds but beds can´t talk or hear or anything like that. She did not want to be operated on again. She didn't want to be the person on the table. Three times was more than enough. Meredith does not want to add a fourth time to it.

Meredith is desperately trying to ignore the fact that no one knows what is wrong with her, well, she chose that no one knows. She didn't have a problem, she assured herself, knowing that she was wrong. She avoids, and ignores and denies that she has a significant medical problem but it ultimately does not work, at least not in the long row.

The truth will come out at some point.

The first surgery was a pulmonary artery banding and the correction of interrupted aortic arch six days after her date of birth, in order to stabilize her first and the next surgery, the so-called atrial switch by Mustard or Senning came after three months, and the third surgery was the one where they corrected the Right Ventricle Outflow Tract Obstruction at the age of five years. Meredith tried not to think about it, but she thought about it anyway.

She knew it. She knew she has to go to a cardiologist specialized on treating adults who were born with a heart defect, to leave clarify the cyanosis. But she wasn't able to. Sure, she could ask Cristina if she would do it. Cristina could perform an echocardiography all by herself, Dr. Burke trained her well.

But that means she has to tell her, but that is easier said than done ...

Everyone would stare at her, and that she couldn't take. She just did not want to. Maybe they expect her to be forthright with her health. But does that matter? She still preferred people not knowing about her medical condition. But for the first time she began to question whether this was a good decision or not.

Well, she could perform a cardiac echo on herself, but, however, it's difficult to perform this on her own heart.

You would not get it right with the different views. Or Burke could. No, he couldn´t, because then everybody would know. Dr. Miranda Bailey, her superior and the Chief of surgery would know it by then. And then everything would be different. She was aware of what people still thought. It was either that or the other one, a lot of times it was this way, they were viewed one of two ways and that sucks. It does. Meredith knows that from experience, sadly. She'd been dealing with this her whole life. People are either sick or healed. Dying, or cured. There is no middle ground, no adaptation. Except for some people, there was middle ground. She was one of those people. But Meredith was constantly trying to adapt to her current situation, day after day, not knowing what the next day will bring, she is constantly adapting to whatever her body is doing at any given moment. She is trying to learn how to live. She can't tell them, can she?

They would act differently and look at her differently even if they are physicians, because that is a normal reaction when people discover she is different from them. She wants them to act normal.

Damn, why does this have to be so difficult? She took a ragged breath.

And in top of that she was an intern and interns could not simply take time to go to the doctor. Interns practically live in the Hospital with all the night shifts and the trolling for interesting cases. Restless, she ran into the hallway and down the next available beds. She had to think. This could not go on like this. She would probably get into trouble if nobody knows. Meredith buried her head in her hands and for a moment, she felt like giving in and crying. She was alone, her chest heaved with every breath she took. She felt like everything she knew slipped away, just like that.

She had to tell someone. Eventually, it would come out anyway. Why not tell Cristina Yang. She was her person. But then it occurred to her. She had forgotten one person. One very important person. He was very important to her. He showed her feelings that she didn't know existed.

Derek.

She could not tell him. He would be worried sick about her if he knew about her medical condition. But that was normal, right? She'd never done this before and if she was honest, it kind of scares the crap out of her. Little did she know that he already suspected something was wrong due to her actions this morning – well she did not forget that what happened then. So she would just tell Cristina who was her Person.

And she wouldn't tell anyone except her when she is ready for it.

* * *

Cristina just finished her surgery with Dr. Burke. "Okay, we're about ..." He said as he put in the staples by using the stapler. She was watching him as they closed the patient up. "Cristina?" He stopped her as she was leaving the scrub room quickly. "Yes, what? I need to talk to Meredith. It's urgent." She said sounding stressed. "Wait. Cristina. Wait." Burke said, holding her back. Cristina turned and faced him. "What is it?" She asked. "I have a thing to do." She added. "I know that you're usually much more attentive." Dr. Burke looked at Cristina. She saw that he was worried.

But he shouldn't be, he should rather do a cardiac echo on Meredith ...

But she didn't say anything. She wouldn't do that to Mer who trusted her. Cristina looked puzzled, and then stuttered with a slight grin: "No, no, I..." She stopped. But then Cristina shook her head. "You know, that's just stupid. I'm leaving now. I have no time for something like that, really." Cristina Yang turned around and left Burke standing in the scrub room. Dr. Burke watched her go skeptically. That was not Cristina Yang, he knew. Something was going on.

The Cristina, who he knew was enthusiastic about all possible cardiac procedures. But today she had been distracted. So much had been pretty obvious throughout the surgery.

* * *

Dr. Bailey on the other hand just finished her procedure and was on her way to find Meredith to talk to her about what happened in there. She walked through the hallways and promptly, she was running into a charming surgeon who was tall and likes to lean against things, plus he is obsessed with his hair. Anyway, that is not the point. "Shepherd, it's a good thing I ran into you." "Dr. Bailey, in a hurry as always." Derek said as he smirked. But Miranda Bailey did not have the time for the McDreamy show. She needed to find Grey. "Shut it, Shepherd. I have no time for this." "You know I am your boss?" Derek asked, blinking in confusion.

"That I am aware off. But you don't scare me." Bailey huffed.

Derek stopped. "Do you need anything?" He then asked.

"Do you know by any chance where your girlfriend is?" Bailey asked him sighing. Derek shook his head. "Is everything okay with her?" He then asked, remembering the meds from this morning, a not so good feeling ran through his body, instantly he started worrying.

"Honestly?" Miranda Bailey asked with a frown covering her features. "I think she is not telling us everything." "Telling us everything about what?" Derek asked concerned. He had some idea what this was about but …

"Her medical history, Derek." Bailey let out a sigh.

"Do you know where she is? She just ran out of my OR with what seemed like troubled breathing. I tried to convince her into paging Burke but she wouldn't let me." Bailey sighed. Sometimes, it seemed like she had more trouble with her colleagues than her patients. Meredith dating Derek, McWife showing up in Seattle out of blue, Cristina collapsing due to an ectopic pregnancy, Meredith almost getting blown up by a bomb in a body cavity, Meredith in need of an appendectomy, Izzie cutting LVAD wires and quitting the job in the aftermath after stealing a heart for him who dies after getting that heart, the prom sex with Derek (Bailey knew whose panties where on the bulletin board even though Callie covered for Meredith) – and now this: a potential cardiac thing going on with Meredith.

It was always them, it was always her interns. Derek stared at her. "No, I don't …" He exhaled slowly, trying to think of what to say. "I don't know where she is. I'm sorry …" In this moment, his pager beeped, interrupting the conversation.

"I have to go, my patient's crashing." He said before running off toward the patient room.

* * *

Meanwhile, Bailey wasn't the only searching for Meredith. Cristina ran through the corridors, in the hope of meeting Meredith Grey. Instead of meeting Mer she met Izzie and George, whose shift started in five minutes. She groaned inwardly. This was exactly what she did (not) need. Izzie Stevens smiled perkily at her. George seemed more tired and not in talking mood. "Hey, Cristina." Izzie called cheerfully. She was always cheerful. "Iz." Cristina replied in her typical for voice. "I didn't expected you here." She added flatly. Izzie frowned. "We're here to do _our_ jobs. Being a doctor and all." She said.

Izzie looked at her funny. George watched them. "Cristina, is everything okay? You seem a bit off and you're acting weird." Izzie noted something was off about this. Izzie wanted to know who noticed Cristinas somewhat worried expression. Cristina turned around and said, shaking her head: "Yes, sure. What did you think?"

Izzie took a sip of coffee and then said: "Have you seen yourself? You look like you've seen a ghost..."

Izzie made hand movements. "Izzie." George hissed softly he stands next to her. She turned around and said soothingly. "What´s the matter? I was just ..." "I have to go. It was nice talking to you but I really have to go," Cristina said and disappeared over the catwalk. Then she thought of the basement. It where the interns spend their free time between surgery and patient care. Finally Cristina had found Meredith. She had been in the basement. As Cristina echoed footsteps in the corridor, Meredith turned around, obviously startled by Cristina's sudden appearance.

Instantly, her breathing quickened and she struggled catching her breath for a few seconds. That was not good. This was not good at all. After a few seconds, Meredith calmed down and her breathing slowed down noticeably.

"Meredith." She spoke.

Cistina watched the scene concerned. Meredith walked over to one of the gurneys and let herself fall onto them. She turned away from Cristina. Cristina followed her friend a bit further and sat down as well. She eyed Meredith for a moment before started to speak. Cristina's back was leaned aganst the wall and Meredith desperately avoided to look at her.

"Mer." Cristina said quietly, but with a strong voice. "What was that?" Meredith looked at her friend confused and then said: "What was what? What ... what do you mean?" It was better to pretend everything was alright even if it wasn't. Cristina looked at her friend in disbelief. "You know exactly what I mean." Meredith should have known that Cristina would not let go. Cristina knew Meredith wasn't good at keeping secrets. She would cave eventually.

Meredith looked at her innocently and decided to pretend she didn't what Cristina was talking about. "No, I do not know." She argued. Cristina saw her in person punitive.

"The shortness of breath and cyanosis? Dammit, Meredith, you're a goddamn doctor, so please behave that way. It's for your health, not mine. And I do care about you, because you are my Person- the best friend I've ever had and you´re too risky with your health. If something's wrong with your heart, you have to be careful and you definitely should go see a doctor about whole ´Your face is turning blue´-thing, you now?" Cristina Yang finished her lecture.

Meredith looked down. Finally she said: "But it's nothing, I'm fine ..."

She lied.

Cristina shook her head firmly. "No. You're not fine, I can see that. You're anything but fine. I can tell." She said resolutely. "You're lying to yourself. You're definitely not okay. Something is not right. I know you well enough to know that."

Cristina looked at Meredith and continued: "... Come on, Meredith. Tell me what's going on and I'll schedule an appointment with Dr. Burke for you. I'll even make him swear that he keeps his mouth shut, but go see a freaking doctor." Meredith rigorously shook her head. "But why not? You need someone to check it out." Cristina tried to get her to understand. Meredith still has not said anything that resembles words and sentences you could understand. There is absolutely no way she would undergo here at Seattle Grace an examination. As of then half the Hospital would know after a day that she had been here as a patient. There was no way something concerning the staff of the Seattle Grace Hospital could be kept a secret, furthermore, she was a magnet for the gossipy crap starting with her relationship with Dr. McDreamy. Because of those chatty nurses, who love gossiping. You could also say that it's that what they do if they have nothing to do. Okay, that mean, but the nurses really are chatty. And thus the questions. No way.

There was no way she will go through that as well.

"Meredith?" Cristina's voice sounded slightly fearful, as Meredith looked away and said nothing. Suddenly Meredith raised her head and looked Cristina straight into the eyes. "No," Meredith said quietly. Her voice trembled slightly. "Uhuh, you don't get away with this. I won't let you 'cause I care about you. I know you have these trust issues but I am me, I am Cristina, your person as I am sure you know but the point is, Meredith, you're not in this alone. You are not. You may feel like you are with your mother being in a home and all but you're not." Cristina wasn't about to give up on her.

"Well, I am. I've been dealing with this for years and years and years and I've accepted that. I have been dealing with this for the majority of my life, in fact in birth." Damn, maybe she'd said to much. Way too much information.

"So, what is it?" Cristina asked, bluntly as she looked Meredith straight in the face.

She was growing worried about her because something was as sure as hell not right. There was something - medically - going on with her and she just can't seem to pinpoint it. As much as she wanted to, she can't and Mer won't tell anything. "I am not saying anything." Meredith was stubborn and intended on not telling anything about what is going on with her. Cristina shook her head in irritation. There was something.

"Mer, this becoming ridiculous, I wanna help you and you won't let me, no. You'll get your heart examined, even if I have to kick your butt all the way to get you there." Meredith was silent. Then: "Why are you so sure it's my heart?" She asked. "It doesn't matter how I know or what I know. Fact is, you need to get checked out, Mer. I mean it. This isn't normal."

"So what is normal?" Meredith shot back furiously.

"Normal as in healthy, Meredith. And cyanosis isn't something that indicates anything good." Cristina said, sighing. "Look, I want to help you, I really do but I can't if you don't let me in."

She did not know whether she should Cristina tell about it or not. Should she tell her 'bout the fact that she was born with a heart defect, that she´d to have open heart surgeries in order to have a shot at living. Sure, if Cristina knew, she would drag her to Dr. Burke to get her heart examined and Dr. Webber and Dr. Bailey would know. No, that was absolutely impossible. Meredith didn't know what would happen then. Perhaps they would even throw her out the program. It could be.

She cannot risk getting kicked out of the surgical program. It was her life besides spending time with Derek and Cristina. It would make her ordinary, a failure. She wouldn't have that. "Cristina, we talk about it tomorrow." Meredith decided. "No, Grey. We talk about it now." Cristina disagreed sharply and pushed an unruly black curl away from her face. "Bye, Cristina. I still have to check on some of my patients." Meredith said smiling. "You cannot just leave now. This is your health, Mer." Cristina exclaimed dumbfounded. "You know what? Have it your way. It is your life, not mine. I am here for you if you need me or want to tell me." Cristina decided to give it one (last) try. You don't leave the people alone you care about.

She won't do it to Meredith. Not _now_. Not in her situation.

Out of the blue, Meredith felt the need to go to Joe's and do some shots to drown her sorrows but In this case, she doubted that she would feel less crappy afterward. Alcohol wasn't going so well with her system right now. Not with her heart not doing what it should do. It would put too much strain on it. So she wouldn't, couldn't do this.

"As you see, I can." Meredith replied and went away. "And I will." "No, you will not, because we are definitely not done talking, Meredith." Cristina called after her with a worried expression on her face. But Meredith acted like she didn´t heard her and soon disappeared out of Cristina´s sight. Cristina sighed and let herself fall on one of the beds in the empty hallway.

If that goes well ... Well, she could only hope. It's all she can do for now.

* * *

**_A/N: Here is some information about the heart defects I have mentioned earlier in my text. _**

**_Let´s start with Taussig- Bing Anomaly: The Taussig-Bing complex is a very rare special form of TGA (a partial TGA). The aorta arises from the right ventricle and the pulmonary artery "rides" on a ventricular septal defect and receives blood from both ventricles. The venous blood from the systemic circulation flows through the right atrium into the right ventricle, into the aorta and is transferred to the systemic circulation. The oxygenated blood from the lungs flows through the left atrium into the left ventricle and then to the larger part of "riding" through the pulmonary artery (the so connection both to the right as the left ventricle has) back to the lungs and to a lesser extent by the ventricular septal defect into the right ventricle and then through the aorta into the systemic circulation. The result is an overload of both the lungs and the right heart, which can lead to the failure of both organs. Often associated with coarctation of the Aorta and interrupted aortic arch. _**

**_Then I´ve mentioned a heart defect called AV Canal Defect. It means there is only one atrioventricular valve (normally there are two: tricuspid and mitral valve), lengthening of the left ventricular outflow tract, not restrictive ventricular septal defect (large hole between the chamber) and atrial septal defect (hole in the atrial Septum). This leads to a constant left-to-right shunt between the right and the left ventricle and the right and left atrium. It causes heart failure, pulmonary hypertension and in final stages, Eisenmenger´s reaction (chronic cyanosis). _**

**_Junctional Ectopic Tachycardia (short JET): is characterized by rapid heart rate for a person's age that is driven by a focus with abnormal automaticity within or immediately adjacent to the atrioventricular (AV) junction of the cardiac conduction system (AV node– His bundle complex). JET primarily occurs in 2 forms: idiopathic chronic junctional ectopic tachycardia, which is observed in the setting of a structurally normal heart, and transient postoperative junctional ectopic tachycardia occurs following repair of congenital heart disease. In normal individuals, electrical activity in the heart is initiated in the sinoatrial (SA) node (located in the right atrium), propagates to the atrioventricular (AV) node, and then through the bundle of His to the ventricles of the heart. The AV node is limiting the electrical activity that reaches the ventricles of the heart. This function of the AV node is important, because if the signals generated in the atria of the heart were to increase in rate , the AV node will limit the electrical activity that conducts to the ventricles. For instance, if the atria are electrically activated at 300 beats per minute, half those electrical impulses are blocked by the AV node, so that the ventricles are activated at 150 beats per minute (giving a pulse of 150 beats per minute). Another important property of the AV node is that it slows down individual electrical impulses. This is manifest on the ECG as the PR interval, which is about less than 200 milliseconds, the time from activation of the atria (manifest as the P wave) and activation of the ventricles (manifest as the QRS complex). Individuals with JET have a "short-circuit" in their heart, where the electricity bypasses the AV node, causing the heart to beat faster than normal. The cause of the arrhythmia, the ectopic focus, is usually near the AV node in the triangle of Koch (a rough triangle with points at the coronary sinus, the tendon of Todaro, and the tricuspid valve)._**

**_Interrupted aortic arch (IAA) is the absence or discontinuation of a portion of the aortic arch._**

**_Thanks for reading..._**


	4. Chapter 4

**Chapter 4**

* * *

**As surgeons, we live in a world of worse case scenarios. We cut ourselves off from hoping for the best because too many times the best doesn't happen. But every now and then something extraordinary occurs and suddenly best case scenarios seem possible. And every now and then something amazing happens, and against our better judgment we start to have hope. As doctors, we're trained to give our patients just the facts. But what our patients really want to know is- will the pain ever go away? Will I feel better? Am I cured? What our patients really want to know is- is there hope? But, inevitably, there are times when you find yourself in the worst case scenario. When the patient's body has betrayed them and all the science we have to offer has failed them. When the worst case scenario comes true, and clinging to hope is all we've got left. **Meredith Grey, Wishin´ And Hopin´

* * *

"Dr. Grey." A voice called behind Meredith. No, not yet. She wasn't ready to face anyone, especially Bailey who had her ways to get what she wanted to know. But she also had no choice. No real choice, at least. Abruptly she turned this around to see who it was. At the same moment she saw Dr. Bailey coming over to her with an expressionless face. "Dr. Bailey." Meredith stammered. "What happened in there, Grey?" She asked. "An explanation would be nice." She eyed her intern suspiciously. Meredith let out a deep sigh. Dr. Bailey looked at her encouragingly. "I do not know." She answered."You do not know. You don´t know?" Dr. Bailey repeated with a sharp, disbelieving voice, the sarcasm clearly indicating that she did not believe the young soon to be- surgeon.

Bailey huffed. Meredith swallowed, her throat felt suddenly very dry. "Of course you do and you just won´t say it. I am Dr. Bailey, I know everything, so I do realize something´s wrong." No, you don't know everything. But that's okay. Okay, it is not. But what should she do without getting fired? Meredith didn´t move, she just waited for Dr. Bailey to continue. "Do you think I approve your unprofessional behavior in my OR, Grey? In my OR you will behave properly. Otherwise I will make sure, you won´t see the inside of an operating room for the next month. Now, do you have a reason why you did leave my OR in the middle of surgery? What was more important than your patient who was being cut open?" Dr. Bailey ranted.

_Shit. Damn it._ She didn´t plan on telling her that way. Meredith shifted uncomfortbly. "I ... umm ..." Meredith began, she did not know what to respond. Her mind was empty, blank. She honestly had no idea what to tell her superior. Dr. Bailey glanced at her assistant doctor invitingly. "Spit it out, Grey. I'm waiting and I don't have all day." She said sharply to Meredith. _Don't you think I know that? I can't tell you, I can't tell anything. If I do I am screwed. Really screwed. I can't. I just ... I can't._

When Meredith did not respond to her question she said, her brown eyes were fixating on Meredith who stared to the ground and seemed to have a great interest in the floor: "What about the cyanosis? Did you at least schedule an appointment with a cardiologist to get it checked out?" She asked. Damn, Bailey's good, she is really persistent. And she cared, otherwise she wouldn't do that. When Meredith shook her head ruefully, she said: "Grey, you are a doctor and when it comes to your health, you are being reckless, so please, do me a favor and go to a cardiologist, Grey. That´s an order." Meredith did not reply. "Grey." She said. Meredith still stared at the floor.

"Grey." She repeated, slight impatience in her voice.

"Listen to me." Finally, Meredith looked up. "You need to see a doctor. A doctor whose specialty are hearts. Cyanosis is a warning sign. You shouldn't take that lightly." appealed Dr. Bailey on the younger doctor's reasonal thinking. She was not about to give up on getting her intern set up with an appointment with a cardiologist. "I know. I should, but I don't think there is anything to worry about." "Grey, don't try and fool me. I know things. Cyanosis is serious, there can be plenty of causes."

"I know." Meredith replied, suddenly standing up for herself.

"Name me some causes. And then tell me why you won't see a doctor." Bailey insisted.

"By abnormal haemoglobin types like Methemoglobinemia, Sulfhemoglobinemia etc. Peripheral Cyanosis. Pseudocyanosis." Meredith answered, intentionally letting out lung problems like COPD and cardiac conditions like heart defects that can also cause cyanosis. Not only peripheral cyanosis, central cyanosis. "That's not all. Come on, Grey. We all know, mostly cyanosis is caused by the circulatory system, meaning heart or lungs."

Meredith looked to the ground. "I know." "You know." Bailey eyed her intern, inquiring her like that didn't make fun at all. She was worried about her. She wanted to help her but this girl's so damn stubborn and won't let her help Meredith. "But if you know what cyanosis, these conditions, can do to you, why the heck won't you go to a doctor?" Bailey wanted to know. "I am new in town, I am in intern. I don't have time to get off work to go to the doctor's. I have night shifts, normal shifts, I am completely booked, not to mention throwing extra shifts in the Emergency Department. I have no time. And I don't need an appointment. I don't need it." She answered, her voice wavered a bit. Bailey noticed it too. Meredith saw the look in her mentor's eyes.

"I'll give you a day off." Dr. Bailey offered, for once her voice was soft, gentle.

"I don't need it. I have work. No time to go to a doctor." Meredith replied, thinking about how she can escape this discussion with her superior. Her superior did not look like she will let her go very easily.

"Grey. You are acting irresponsible. I can do your blood work, send it to the lab and we'll know if it has something to do with hematology. We can also do an arterial blood gas determination and a pulse oxymetry. Nobody has to know." "I don't think that that is neccessary." Meredith said. "I am fine. I am perfectly fine. It is just peripheral cyanosis." She lied right into Bailey's face. "Somehow I don't believe you." Meredith shrugged.

"I am fine. You don't have to." She turned to go.

"Grey. Wait." Bailey called after her, sighing. "Go to a doctor. If you don't, you are banned from surgery for the next two weeks. Are we clear?" Meredith shook her head. "We are not. I am fine, I don't need to go to the doctor." She insisted. "You will go anyway. Before you get yourself checked for any hemoglobin conditions, cardiac conditions and lung conditions you won't set a foot into the OR." She threatened.

"But this isn't fair." Meredith protested.

"You were cyanotic. You have to get yourself checked out. Cyanosis should be taken seriously."

"Cyanosis? Who mentioned cyanosis?" The voice of Chief Webber came from behind Dr. Bailey. Meredith turned around, completely frozen. Her Instincts told her to run, to get away, just... just don´t stay here. But she couldn´t move. Panic was in her eyes, utter panic. Adrenaline flowed through her veins and arteries but she just could not move. She was frozen.

"Dr. Grey, Dr. Bailey. Anybody care to answer?" Dr. Webber ordered with his sonore voice. Dr. Bailey saw the panic in her intern´s eyes and covered for her.

She quickly said: "We were talking about a patient. Nothing is going on, Chief." "Aha." Dr. Webber was not convinced by this explanation. Something was off and he just couldn´t figure out what. They were not talking about a patient. That was clear. He had seen the frightened look on Meredith's face when he appeared. And a look in Bailey's eyes told him that they weren't just speaking about a patient.

"And the patient who is you, Grey? Are you the patient?" He asked suspiciously. Meredith was startled. Dr. Webber had been sitting in the gallery. Had he been sitting in the gallery? She hoped not. Because if he had been there she was in so much trouble. "I have to get the labs. Excuse me." Meredith's voice quivered when she rambled an excuse to get away from here. Dr. Grey escaped. Only when she turned the corner in first gear, she stopped. Breathlessly, she was taking some shallow gasps. That short run had been really hard on her.

Maybe Bailey was right and she should go to a cardiologist. But where? And when?

She had no time, she was an intern. The hospital owns them.

And she can't do an echo on herself, she needed someone else to do it.

Her heart beats shallow in the chest. Breathlessly she gasped for air. For Meredith, it seemed as if she would have make an stronger effort with each breath, to take in enough oxygen, the amount her system needed to function properly. She hoped this feeling would soon disappear ... Meredith's breathing only calmed down slowly. Damn, that was a bad sign, a very bad sign. She looked at the clock, she thought about taking a short break.

She needed that break. She had been here seven hours or eight hours without a break. She did not even thought about thinking. Water. She really needed water. Water was important for her heart. She drew in a deep breath, closed her eyes for a moment and relaxed.

She sighed relieved. She did not admit it, but the twenty four hour shifts demanded yet more from her than she liked to admit. It had been easier when Meredith started her internship. Now, it was hard. Because of her heart but she can't show more weakness than the others. It would make the others think that she couldn't held the pressure. Ellis Grey's daughter, a failure. Who did not get through internship. Damn it.

"Grey, what you are doing here? Go get the lab results like you claimed you would do." Dr. Bailey accused the assistant doctor to a searching look. Tiredly, Meredith nodded and went on her way. Thoughtfully, Dr. Bailey watched her leave. "Damn fools." Dr. Bailey muttered to herself, as she watched Meredith walking away.

"The results of Mr. Martin Sadds for Dr. Bailey. If it were possible, could you hurry up with that?" Meredith Grey leaned against the wall, as the man at the counter with an arrogant tone said: "Everyone needs everything ASAP." "Yeah, sure." replied Meredith. "I need the results right now. As you would say, as soon as possible. So could you just give me the damn labs?" Without returning a word, the man disappeared into a room and returned shortly thereafter with the lab results. "Well, that´s it. Wasn´t that hard, was it?" Meredith said with a wry smile. She rolled her eyes inwardly.

"Umm." The man responded grumbling, his name tag said Mesroe, Jack. Idiot, Meredith thought. What an ass. A complete, dumb ass who has to much free time. Meredith shook her head disapprovingly and was leaving.

* * *

**Flashback: Meredith, three months**

_Meredith was now three months old. Now the second and hopefully final surgery would take place. They planned on performing an atrial switch invented by cardiac surgeon Senning. Due to the complicated relationship of the great arteries an Arterial Switch Operation is not an option, so the only options were: Atrial Switch Operation or Damus- Kaye- Stansel- Operation. Which meant that there was no way to correct the underlying defect / anomaly of the heart. _

_The Damus-Kaye-Stansel operation (DKS) with VSD patch closure and conduit implantation between the right ventricle and Pulmonalis trunk is required when there is a high grade subaortic stenosis and under certain circumstances this consuming and difficult operation. The lead pediatric cardiac surgeon anastomoses the Pulmonalis trunk with the aortic root (which is called DKS anastomosis). The former pulmonary valve becomes a neo-aortic valve. Furthermore the surgeon closes the ventricular septal defect with a patch so that the left ventricle drains (former pulmonary valve) in the neo-aortic valve. The lung perfusion is ensured by the implantation of a conduit between the right ventricle and distal Pulmonalis trunk. But since Meredith has no high grade subaortic stenosis, the surgeons tended to the other surgery: Atrial Switch Surgery.  
_

_Alternatively an atrial switch by Mustard would be a different course of treatment. The only difference between Senning and Mustard is that by the ´Mustard-Method´is used foreign material and ´Senning- Method´ uses in reverse to ´atrial Switch by Mustard´ the patient´s atrial tissue. But that was not the only option. The REV method (réparation à l'Étage ventriculaire), an intracardiac tunnel or Rastelli- operation would have been possible treatment options for a "double outlet right ventricle" with an sub aortic ventricular septal defect, but since Meredith´ VSD was sub pulmonic these surgeries weren´t doable anymore. _

_The Rastelli- operation is the surgical correction of a so-called d-TGA simplex (without other defects): the blood is passed by means of a tunnel-shaped patch from the left ventricle to the aorta, the existing VSD may need to be extended, a conduits takes the blood from the right ventricle to pulmonary artery once the Truncus pulmonalis is closed from the left ventricle.)_

_In the atrial switch operation, the atrial tissue is cut so that the system venous blood passes through a so created pant shaped atrial tunnel and it gets into the pulmonary artery. The pulmonary vein blood flows past the tunnel in the right ventricle. Meredith' ventricular septal defect was closed with a tunnel patch that passes the blood from the left ventricle to the pulmonary artery. At the same time the AV Canal Defect has been fixed with the double patch technique. In the double-patch-technique cardiac surgeons closed the Ventricular septal defect and atrial septal defect with two different patches. _

_After VSD closure with the first patch the bridge sails of ASD were fixed with assignment to the ventricles at the patch, sewn the "cleft" and closed with a second patch. _

_This method is more complex than the single-patch technique; However, in this case the fragile AV valve tissue must not be incised. After they were finished with the whole procedure, the heart surgeons started to warm her up and let her heart beat on its own again. The lead surgeon also implanted an external pacemaker in case of arrhythmias. But that was just precaution and therefore only transiently and will be removed once she gets discharged. _

_She spent circa five days in the PICU and was then moved to a regular room.  
_

* * *

Meredith was searching for Dr. Bailey to bring her the required laboratory results. Dr. Bailey was waiting impatiently. "Where have you been, Grey. I was waiting for you." Dr. Bailey could be really nasty. Meredith muttered softly to herself: "No, just a lecture about ASAP was held." Fortunately, Dr. Bailey had not heard this. "The patient in room 1236 needs a new enema, a patient in room 1570 needs rectal exam and then there is a consult in the emergency department. Sixteen-year old heart patient with unexplained syncope's. Have fun, Grey." Dr. Bailey said, as she was loading Meredith with a stack of medical records. "And I expect complete medical reports of all postoperative patients, including long-term ECG. If it is not there, make one yourself."

"Oh, that´s just great." Annoyed, Meredith looked at the medical records. No break for her. Damn it, she needed that break. Why can't she just make a damn break, just for ten minutes. But now? Now she has to update charts. Probably it is punishment for what happened in the OR. The emergency room was empty for normal conditions. Just two beds were occupied. Bed five, Dr. Bailey said. She took a short glance through the patient´s medical records, before she said half loudly: "Ah, screw it. I am going to do the consult first." She did not intend on letting her patient in the ER waiting for so long, since there might be chance that this girl or boy has a cardiac rhythm disorder or anything else. She looked at the file before she attended to the patient. There was noted that the patient has a history of previous heart problems related to the fact that she was born with a CHD.

Slowly she made her way to her patient. The girl and her mother were waiting patiently.

"Hello, my name is Dr. Grey and I'm the doctor. You are Lily McGee and suffer from unexplained syncope's? Is that right?" The girl looked a bit shy and nodded slightly. "You don´t need be afraid. You are in very good hands. We will make the normal studies as when you go to your cardiologist." Meredith smiled kindly. Lily nodded, she seemed nervous and scared."Okay. Then we will start with the echo and then we are running an ECG. Dr. Burke, our heart surgeon, will come over afterwards and then discusses the results." explained Meredith calmly.

"You have a heart defect?" She asked, looking at the girl, who was sitting on the bed. She looked to the ground and looked like she didn´t want to be here, which was totally understandable, at least for Meredith. She knew what this girl felt. When she was her age, she had a similar expierence, just with a syncope and a sudden awakening in an ambulance on the way to Seattle Presbyterian. "Yes." She said softly. Her mother sighed, looked at her daughter and said: "She has a double outlet right ventricle with Fallot- type." Meredith swallowed, and tried not to let show how much she identified herself with this case. She had been there so many times.

"She is shy." The mother said. "She has always been like that." The girl looked up, her gaze slid to her mother. Anger and frustration were on her face. "Mom, stop it." She hissed. "It's none of her business. We are just here to find out why I keep fainting. Believe me, fainting in front of the whole class is downright embarrassing."

"I can think that it was not a really good expierence. But, no worries, we will find out why. "Have you noticed any other symptoms? Cyanosis, change in heart rhythm etc." After she did a thorough case history, she made sure that she left nothing out, she said: "It's okay. I was like that too." Meredith smiled warmly, reassuringly. She had a good way with patients.

"I'll be right back." She apologized hastily and left hurriedly the ER.

* * *

**Flashback: Meredith, seven years**

_"Meredith, come now," cried Ellis Grey. Meredith dawdled again. They had yet to pediatric cardiologist for the follow-up. They scheduled the follow-up in one year Intervals, but anyway, it depends on the results of the echo and ECG when they schedule the next appointment to see if there were any changes in her condition, which, frankly, she did not hope. Meredith seemed normal too, she wasn't easily tired or got dizzy spells or anything. No, she really seemed let's just hope that the exam will not say otherwise.  
_

_"I'm coming.", Meredith called back and came after a few minutes stormed down the stairs. "Then we can go." Ellis Grey said relieved, because it was embarrassing to be late to a doctor's appointment. Well, if things get in the way, and it´s not your fault and you can´t do anything about it, if for example a surgery takes longer than planned, that's fine. "Mom, can we eat some ice cream afterwards?" "If you do what the doctor wants you to do and you do it without any discussion, well, then I think about that." Ellis replied and turned her attention to the road. Then they arrived at the practice. Luckily they had not wait for long. _

_Meredith hates going to the doctor´s, okay, she is seven years old and which seven year old wants to go the doctor? "Hello, Meredith." The doctor greeted Meredith and squatted down in front of her. "Well, then, let take a look at your heart, hm." He laughed and stood up again and shaked Hands with Ellis: "Dr. Grey Nice to see you." After a brief conversation of it went over to the room on whose door stood echocardiography. "Well, Meredith, then make your upper body free and lie down for me." He told little __Meredith. _

_While Meredith made her upper Body free, the doctor left the room. When Meredith was ready, he entered the room. "Attention." He warned Meredith, whose eyes where fixated on the Monitor showing films about the ocean. The light in the echo room was slightly dimmed so that the physician could see the image on the monitor more sharper and better. "It's getting cold now." He began with the four-chamber view, then wandered over to the two - then three-chamber view. _

_Ellis looked at the screen to make sure, nothing would be missed. Then the apical five-chamber view. Next, the pediatric cardiologist echoed the heart valves, first the aortic valve, then the pulmonary valve and then the mitral valve and at least the tricuspid valve. After he had the heart looked at the various scan views and in M-mode, he ended the sound satisfied. It was all okay, without any big pathological abnormalities besides a little hole between left and right heart with a small left-to-right shunt. It was a residual defect. Maybe it would close itself within time._

_"Now only the short-term ECG and then the 24h ECG." "Oh no." Meredith protested, horrified. She hated that. These dots terrible on the skin when removed. "But, Mer, you have to do it, the doctor needs to see if your heart is beating properly." Ellis told her struggling daughter and tried to calm her. Finally it worked. Meredith lied down and the pediatric cardiologist was able to record her heartbeat. Ellis was looking over the doctor´s shoulder, making sure that the pediatric cardiologist nothing missed on the electrocardiogram._

_After two to three minutes they were finished. "So, we are finished here." The physician said and began to disconnect the ECG leads. Then there were the electrodes left. "No. No. No. I don´t want that." Meredith protested, she knew what came after disconnecting the leads. These electrodes were evil. They "hurt" the skin whenever you pull them off. "Meredith, pull the ECG points slowly off and Put pressure externally with your finger against the ECG point, that it does not twinge as much as it does now." The man in the White coat advised, when he saw the girl struggle with pulling off the electrodes._

_When Meredith was fully clothed, equipped with Holter-ECG that is supposed to record her rhythm for twenty-four hours, he wanted to make an appointment for the next for the next __cardiac catheterization. "The last __heart __catheter exploration we did was four years ago. I´d like to do one every three years, so that means we have schedule one in the near future."_

_Ellis nodded. She understood that. When she was finished scheduling a appointment for catherization, she and her little girl left the doctors practice. "Mummy, what about my ice cream." Meredith protested when Ellis was walking towards her car. "Psst, Mer, I will get your ice cream. But first, I need to get some files from the hospital." "But Mummy, you promised I will get ice cream after we went to the doctor." "You will get it. Just try and be patient." "I am done being patient. I don't like the doctors appointsments. The thingies on my chest are hurting. I don't like it. And you, you promised me an ice cream." Between Meredith's whiny behavior, Ellis pulled to the side and stopped the car next to an_ _local ice cream parlor._

_"See." She said. "I told you will get your ice cream." "Thank you, Mommy. I love you. Come." Neredith was happy when she learned that she was going to get her ice cream. "I will chocolate and strawberry." Meredith exclaimed, jumping up and down. "Meredith, just one __scoop of ice cream, okay? If you eat to much, your belly will start hurting." Meredith decided she wanted strawberry ice cream. When Ellis had paid for it, both of them made a short back to the near ocean and looked at the water. Today was windy and a bit cold. "Look, there is a boat."_

_"It's a ferryboat. There are people on it that want to the other side of the city."_

_With big eyes, Meredith watched the sailboats and ferryboats with the passengers. "It's great here. We need to come more often." Meredith suddenly said, her gaze slid over the blue water. Ellis smiled, this was a good day. Her daughter was happy despite the appointment to the doctors office. "Yeah, you are right." She said, thinking about her and Richard being here and looking out of the water. Meredith's voice brought her back to reality._

_"Mummy, look. A small stone. Can I throw it in the water." She wanted to know. In her hand was a little, small stone. Too small to do any kind of damage with it."Yeah, but don't go to close to the rim. The water is very deep and it's ice cold. If you fall, you'll drown and / or get hypothermic. And I don't intend on letting this happen. So, at least one metre between you and the water." Ellis warned and looked attentively at Meredith. "Okay." Meredith throwed the stone into the water and watched it disappear._

* * *

Dr. Bailey was worried. She was really worried about one of her interns. Of course these five don't know how to stay out of trouble. The incident with Meredith in the OR where she turned cyanotic replayed in her head over and over again. This wasn´t normal. Healthy People don´t turn blue for no reason. She was pretty sure that there was something going on, so she decided to talk to the chief. When she finished her surgery, she went to the chief´s office, hoping he was there and not in surgery. She thought about what she should say.

When she walked towards his Office Patricia, his secretary stopped her. "He has a lot to do. A lot bureaucratic things, mails to answer and Budgets to look over ... Short, he doesn´t want any interruptions or staff burging in wanting something from him." "Well, I am not like other staff. I am his favourite resident and I want to speak to him right now. It does concern one of the interns, my interns." Patricia shook her head. "Sorry, but now interruptions." Dr. Miranda Bailey just scoffed and knocked on the door to the chief´s office.

Then she opened it. "Bailey. What are doing here. I told Patricia no interruptions." Dr. Webber told her, obviously surprised that she had disregarded his instructions. He looked up from his paperwork. "Yes, you did. But I ignored it." Bailey said. "Look, this does ..." Dr. Webber told his resident. "it is about Meredith Grey, who is ..." "... like the daughter I never had, yes. Go on."

He leaned back, sighing.

Dr. Bailey nodded and started speaking: "I worry about her, Chief. She turned cyanotic in my OR, but won´t tell me anything."

"Cyanosis? So you weren´t talking about a patient?"

"No, Sir." Dr. Bailey replied, she looked to the ground.

"Thank you for telling me. I will do something about it and find out what is going on- even if it involves speaking to Cristina Yang, maybe she knows something that could be helpful." Dr. Webber told her.

"What am I going to do?" Dr. Bailey asked. "Well, should I confront her another time or just act like nothing happened?" "You know the answer to that, Miranda." The chief just replied. "I do. Thanks for taking time for me and my matter of concern." Dr. Bailey said. "I´ll have another surgery in half an hour. I really should get going." She then leaves the office.

Dr. Richard Webber stared after her, unable to concentrate on mails he us supposed to answer.

He really should find out what is going on with Dr. Grey ... after all, she is Ellis's little girl and nearest thing he has to a daughter. And she may need medical attention.

* * *

She met Derek, who also worked in the meantime. "Hey, Meredith. You okay?" He asked and greeted her with a long kiss. "You look tired." He said after a quick glance. "I have a consult in the pit, oh, and I´m running labs." She pulled away from Derek. "I'm sorry, but I gotta go. I need to find Dr. Burke." Meredith concluded. "Okay. Good luck." Derek told her and pressed her still quick kiss on the forehead before Meredith went to find Burke. Meredith gave him a grin and Derek watched her leave. Finally she found Dr. Burke at the nurses' station.

"Dr. Burke. I've got a case." Meredith said slowly. Dr. Burke held a coffee cup in his hands and looked at her questioningly. "Sixteen-year old girl with cardiac history with unexplained syncope's." "Okay. What about her medical history?" He wanted to know more about that. "She was born with a double outlet right ventricle with Fallot- type." She told him and waited for his answer.

"Okay, this is what you gonna do: run an ECG, pulse oximetry and echocardiography." He ordered. "Page me when you have the results." "Okay, then." She agreed quickly. Meredith took the patient and the mother to the room where the ultrasound machine was. Friendly smile, she invited them in and said: "We´re going to perform an echocardiography and then an ECG, I'll be back in about two minutes," Meredith gave Lily an encouraging smile and left the exam room.

After two minutes she entered the exam room again and reached for the transducer. "Okay, it is gonna be a little cold." Meredith warned the cardiac patient. Then she started with the ultrasound. First the Apical four-chamber view. She placed the transducer on the fifth intercostal space, approx. left midclavicular. The left (LV) and the right ventricle (RV), as well as the left (LA) and the right atrium (RA) can be displayed on the screen, then she turned the transducer aproximately 60° counterclockwise from the previous position. Now she could see left atrium and the left ventricle.

Lily kept staring at the ceiling. The mother stared nervously at the monitor on which a beating heart could be seen. Meredith was fascinated.

Even if she knew what it was like when the heart is malformed or does not beat properly, it's a small miracle. Cardiac surgery was interesting, even if she doesn´t want to be a heart surgeon- now that was rather Cristina, who was crazy about the heart. The Girl was nervous. She knew how she felt. She knew this feeling all too well. Each time when she had gone to the follow-up she experienced this fear, the doctor might discover something and that requires re-surgery. Every time Meredith was glad when it was over again. She hated to be the patient. After Meredith had finished the echocardiography at Lily, the glue dots was stuck on her chest, which was for the unipolar precordial leads (by Wilson) absolutely necessary.

When the glue dots were systematically attached to the left and right parasternal line, one on the midclavicular line and two on the axillary line in the intercostal, Meredith started the recording of the heartbeat. "So, let's get started. Please do not move for three minutes.", told Dr. Grey. There was a special program in the Computer for this. Then they did an stress ECG, which was taken on the Ergometer. After two minutes Meredith noticed Lily struggling for air and instantly looked at her sats.

Her oxygen saturation went down to 95%, which was borderline. So Meredith stopped the stress ECG, and said: "Lily, I say that you may not be able to do sport in the near future, unfortunately." "Why?" Lily asked a little out of breath. "Because your oxygen saturation fell. After three minutes it was only 95%." Meredith continued, trying to make eye contact with the girl. "Can I go home?" Meredith shook her head. "No, you gonna be admitted for further studies, until we know what´s going on. I'm sorry." Meredith said once the pulse oximetry was finished.

After the girl was admitted, they moved her to a patient room. After a while the mother went to get a cup of coffee, Meredith entered the room. Lily was reading and looked up as soon as she noticed Dr. Grey standing there. "Hey, I just wanted to see how you are feeling." Meredith began. Lily let out a deep sigh. "I hate being in the Hospital.", she finally admitted. "Don´t take it personally, but you have no idea what it´s like to live like this."

"Well." Meredith said. "Actually, I do." Lily looked at her in surprise. "Really? You do?" She asked, unsure how to respond. Meredith nodded and sat down next to Lily´s Hospital bed. "Okay, I am going to tell you something. And could you... maybe... Don´t tell anybody. Or mention it when Dr. Burke talks to you about your test results. Because nobody knows and I don´t want anybody to know."

Lily nodded, and waited for her to continue: "I was born with the same condition as you. I´ve had three surgeries. One when I was a few day old, the next after a few months. And when I was five, they discovered that I had a right outflow tract obstruction. They repaired it in surgery."

"I had only one surgery. Why did you have had surgery so many times, I mean, beside the one at the age of five." Lily asked.

"And how did your classmates react, when they found out about your heart defect? Or is that question too personal?" "No, you can ask. You know it wasn´t just an "double outlet right ventricle", I also had an AV Canal Defect and an interrupted aortic arch and Aorta was hypoplastic, which was corrected in the first surgery. Then they did an atrial Switch Operation and corrected in the same session my other heart defect-"

"Interrupted? How is this possible?" Lily was shocked. How could you live with an interrupted aorta? That is impossible. "IAA is often combined with DORV. It´s called a Taussig- Bing- Anomaly. In order to survive, they tried to keep my patent ductus arteriosus open to allow blood flow. A PDA is a fetal Connection between the aorta and pulmonary artery." Lily understood.

"Did your former classmates..." Meredith looked at her patient.

"...know about my heart condition? Yes, they did know. But for them I was nothing. They thought I had some weird kind of special rights, because I often left school because of doctor´s appointments. And then, one day... There was the Thing with me having arrhythmias. I passed out during PE. They had to call an ambulance. But they didn´t understand or neither wanted to. For me it was okay. I dealt with it, but remember being relieved when I graduated high School." Meredith told her patient, who was just listening without interruptions.

"But I had one good friend. Her name was Sadie. She was always there for me. After school we both traveled to Europe and had an big argument. We never talked again. It destroyed our friendship. I went to med School and graduated. Now I am here. I survived. I am going to be a surgeon one day. And I know you will survive too. High School is cruel sometimes, I´ve been there. Just don´t give up. It´ll get better. Keep that in mind, okay?" Meredith finished her monologue.

Lily just listened. But before she had the chance to say something, her mother entered the room. "Dr. Grey. What a pleasure. Is everything okay? Do you have test results?" She asked, placed her coffee cup on the table near Lily´s bed and glanced at her questioningly.

Meredith quickly stood up and explained: "I was just taking her vitals and we somehow ended up talking." "Oh, she talked? She doesn´t do that a lot. I am beginning to think it may be because of her, you know, condition and because of school. She always had been very quiet." Meredith was thankful that Lily interrupted her mother. "Oh, mom, please. Stop it." Lily hissed. "Okay, okay. I´ll stop." "I have to go. Work. I will come back and check on you, Lily. Bye, Mrs McGee." Meredith left the hospital room to give them some privacy.

* * *

_**A/N: Rastelli- procedure**__**: The principle of the Rastelli operation at a d-TGA with VSD and pulmonary stenosis based on the fact that the left ventricle must supply a high pressure through a constriction in the lower part of the pulmonary artery and therefore the light coming from the lungs of oxygen-rich blood through the VSD in the aorta can flow. **__**The circulations are separated at the level of the ventricles by inserting a valved conduits and thus the functional closure of the VSD. **__**The conduit must be replaced later depending on age and time of surgery. Because after this surgery the left ventricle pumps oxygenated blood to the systemic circulation and the right ventricle pumps venous blood to the pulmonary circulation, it is also an anatomical correction. **__**Then I have mentioned a procedure named REV procedure, it is short for Réparation à l'Etage Ventriculaire.**_

_**About the exam room Scene with Meredith and her mother, I didn´t made up the TV with the film about oceans. I don´t know how other doctors distract the children when they get an echo, but my cardiologist does it like that, I mean with the film. Now I always peek towards the monitor to get a chance to see my heart, cause it´s amazing and intense. It is nothing you experience every day. How often do you schedule such an appointment? That depends on heart defect and the severity of it and possible residual defects or any kinds of abnormal heart rhythm. YOur cardiologist will tell you when he / she wants to do the next echo.**_

_**Also, I just had to write the ´Lily and Meredith´- scene in the end. Meredith´ Chance to give advice to a young girl who is in the almost same position as she was when she was in high School. **__**See, that is me rambling. I hope you liked it and hopefully leave a review...**_


	5. Chapter 5

**Chapter 5**

* * *

**Doctors give patients a number of things. We give them medicine, we give them advice, and most of the time, we give them our undivided attention. But, by far, the hardest thing you can give a patient is the truth. The truth is hard. The truth is awkward, and very often, the truth hurts. I mean, people say they want the truth, but do they really? The truth is painful. Deep down nobody wants to hear it, especially when it hits close to home. Sometimes we tell the truth because the truth is all we have to give. Sometimes we tell the truth because we need to say it out loud to really hear it for ourselves. And sometimes we tell the truth because we just can't help ourselves. And sometimes, we tell them, because we owe them at least that much**. Meredith Grey, Let The Truth Sting

* * *

Suddenly Lily yawned loudly, quickly covering her mouth with her hand when she remembered that her doctor was still in the room. "Are you tired?" Meredith asked concerned. "Maybe I should go. Anyway, I have work to do and you're obviously tired. You should sleep." Lily nodded in agreement. "Maybe I should." She said, leaning back into the pillows. "Sleep well." Meredith said and was about leave. "Dr. Grey." Lily called her by name. "Thanks for telling me your story." Meredith smiled and replied with a soft: "No big feelings. I did it because I know what feels like. I wanted you to know that you aren't alone. There a lots of other kids and teens out there who have the same problems. But I probably should let you sleep and quit the whole rambling - thing." Now it was Lily's turn to chuckle. The mother noticed a bond between the young doctor and her daughter and was happy that someone finally got her to talk and open up. Be open, be positive about things.

Meredith made that happen.

"Thanks for talking to her." The mother said quietly when she stopped Meredith when she was about to leave. She already had her hand on the doorknob and turned to leave. "No problems."

Meredith smiled in reply, her blue eyes turned across to Lily and then back to her mother.

She always had a way with patients. "You got her to open up. She's more positive." The mother continued, untouched by her daughter's embarrassed features, and trying to stop her. Lily rolled her eyes when she heard her mother talking. "Mum, she knows it yet. Let her go. She's a doctor. She's got probably more pressing patients than a girl with a heart defect. She has to work. And you are impeding her from doing that. She's a great person. I am sure she will get into trouble when she isn't done with her work in time and maybe her resident will freak out and throws her off my case since she is a junior doctor ... No offence." Lily chuckled lightly.

"None taken. You are right, I am an intern. Wow." Meredith did not know what to say. "Nobody will throw me off your case. I promise, Lily. I won't let them." Meredith assured her. Lily smiled after Meredith assured her that this won't happen. "That's good, because you are my favourite doctor." She then said. Meredith laughed in surprise. "... who orders you to sleep." Meredith replied with a strong voice, firmly. "You shouldn't tire yourself out. It's not good." Meredith warned her. "Okay, I will do as you say." Lily leaned back into her cushions and made herself comfortable. "Good." With that Meredith left the room. Lily was now sleeping and as Lily had pointed out, she had work to do. They talked for circa twenty minutes and luckily, nobody noticed her absence. It felt good to talk about it with somebody who understands. Who has the same problems ... Meredith walked over the floors and started completing the charts and had gotten all the lab results. After Meredith had finished the rectal exam, had completed all laboratory reports for Dr. Bailey (who would be really pissed off if she hadn't), the annoying patient from room 1236 had gotten his enema, which was not a very easy task, because the patient had been uncooperative and his veins were shot. She exited the patient's room and leaned against the wall for a second, waiting for the dizziness to pass on its own. Fluids, she needed fluids, it was probably related to her fast pounding pulse. In this moment, Bailey was walking past her and noticed she was lagging. Damn it, Meredith thought. Her limitations were making her life hell. Plus, she really needs to pee. She felt the pressure building on her bladder.

Bailey turned, her hands on her hips and she looked at Grey with a deep frown. Meredith breathed in sharply. She was trying to ignore her fast-beating heart in her chest.

"Grey, don't think I don't see you're lagging 'cause I see it. This program's rough and I expect you to be on top of your game. If you can't make it through a simple double shift you have no business being in this program. If you can't handle it …" Dr. Bailey noted the pale complexion but since Meredith won't tell her what's going on with her.

Meredith interrupted her: "I can handle it."

But she wondered what she had gotten herself into. "Well, good. Then the patient in post-op 2470 needs his IV meds, and there are a lot of charts you have to go over." "I will do this, but I'm sorry. Is there any chance I can go and organize some fluids? I kind of really need some water." Meredith was aware that she sounded like a complete idiot but heck, she was thirsty. Bailey scowled. "Internship is rough, Grey. But go get some fluids before we're looking at dehydration as well. You collapsing due to lack of fluids would do you nor your patients something even remotely good."

See, we're looking at the softer side of Dr. Bailey, Meredith happily registered. She was grateful for that. "Thanks." Meredith said before picking up her pencil, she didn't even register that it fell to the ground before now. Okay, first bathroom break and then she was going to hunt down some water. Meredith was entering the bathroom for the orderlies, luckily she was alone as she stood at the sink and examined her pale, seemingly exhausted features in the mirror. Apparently, this wasn't one of the good days but it wasn't a bad day as well. She splashed water against her face, water was dripping down her forehead to her chin and cheeks before it enters the water basin below. Meredith sighed. Meredith Grey knew she had to tell them. Her collarbone peeked out beneath her scrubs. She'd always been thin. She tried to ignore her complexion.

But she didn't want to tell them. Yet, again she was there. She turned around to get this done before heading down to the cafeteria. Meredith was on her way to the cafeteria, hoping Cristina would be there. On her way down there she got held up by Dr. Burke who wanted the test results.

"Hey, Grey." Meredith immediately recognized Dr. Burke's voice. The heart patient she had been talking to. That was about her heart patient, Lily McGee. Meredith stopped, cafeteria would have to wait, apparently. "Get me the results of the heart patient in the Emergency Department. I've been waiting forever." He sounded quite annoyed by having to wait so long for some simple studies. Meredith felt nervousness creeping up in her. "Sorry." Meredith quickly apologized. Maybe he had noticed her absence. "Wait, I have 'em right here." She grabbed a chart from the nurses' station and handed it over. Dr. Burke's voice was slightly impatient, as she gave him the results of the exams. "Coming right up." Meredith presented Dr. Burke the results of short-term ECG, stress ECG and the findings of the performed echocardiography in the young heart patient. "Well done, Grey. You okay?" He suddenly asked Meredith who jumped a little bit when she heard the question that was asked. You look a bit pale. Maybe you should eat something. Did you ever take a break these days?" He said genuinely, eyeing the junior doctor. Meredith replied, slightly annoyed: "I am intern. Bailey's on the warpath and break isn't really the first thing on my mind." Meredith snapped at the surgeon. Burke didn't seem affected by her words.

"But you don't look very good." Burke seemed to be persistent as well. Meredith resisted the urge to huff in reply. "Just hungry, haven't eaten that much." Why was everybody worried about her? Meredith's thoughts raced. Was it really that obvious that something's going on with her? Wow, she really couldn't keep this a secret. Damn well job, Grey, she scolded herself. Really, this was so brilliant. This sucks. "Good then, Grey. I will look them over ..." He motioned to the exam results and continued: "... then I will come after you and talk with you about the next steps of diagnosing." Burke told his intern. "Okay. You'll page me, right?" Meredith replied. "Sure, Grey." Then she quickly went to the cafeteria. She really needed something to eat and water. She was lucky.

The elevator was right there. Meredith ran the last few meters and gasped for air as the elevator doors closed. That was close.

She leaned against the wall and worked on controlling her breathing. For a moment, she got dizzy. Then her view cleared and so did her breathing. Slowly her breathing slowed, and Meredith realized she had to talk to Cristina about her heart defect. Her breaths were returning to normal too. If something happens, this information could save her life. But she needed to talk to Cristina Yang, her person. Ok, this is not good. When she does the slightest thing that requires more energy than walking she gets dizzy and her breaths are becoming irregular and hectic. She should tell Yang. Cristina will know what to do.

Finally she reached the cafeteria and looked around the hall. Nurses were sitting on tables and were chatting, laughing with their colleagues. She also saw other doctors. But there was no Cristina Yang in sight. "Oh, screw this universe." Meredith mumbled to herself. Why wasn't she here? She looked around and saw Izzie Stevens, George O' Malley and Alex Karev there. They were already sitting on one of the many crowded cafeteria tables. Suddenly Izzie had to laugh at something, Alex was laughing too. George on the other hand looked as if he had bitten into a sour lemon. Meredith smiled briefly, then she went on to the counter to obtain sandwiches and a bottle of water. Water, she needed water. Plus she should probably hurry up before Burke pages her. Quickly Mer grabbed a tablet, then the much-needed bottle of water and then the sandwiches.

Then she came to the table, where already Izzie and the others were from her year. She noticed happily that there were two seats free. Relieved, Meredith pushed through the cafeteria of Seattle Grace Hospital to get to the table where the other interns were sitting. "Hey, Mer." Izzie said with a friendly tone. "Is everything okay?" She asked shortly after she had studied Meredith's complexion.

"I'm fine." Meredith replied, rolling her eyes.

"Why should I not be okay? Hm?" She asked, her voice didn't tell that she was kind of lying.

"Well, you're pretty pale, didn´t you notice?" Izzie asked back. Meredith shook her head and took a sip of water. The cool water helped. "No, I'm just tired. These 24 hour shifts are not really my favourite thing." She said, partially worn out. In her mind, she counted how many people had told her that she wasn't looking very good: Cristina, Burke, Izzie, Bailey. Four people. Probably more but they didn't say anything.

"You can say that, Mer." Izzie agreed with her roommate as Cristina came into view. But only Alex noticed the Korean doctor coming towards them. "Have you seen Cristina?" Meredith asked. "No, why?" George wanted to know. "I haven't seen her too." Izzie answered. "Why are you always so keen about talking about everything with Cristina? It's like you're a closed little circle and I am on the outside." "Hey, guys." Cristina said behind them. In this moment Cristina came over and let herself fall into the chair next to Meredith and said, groaning: "I hate it." Meredith, Izzie and George stared at her, waiting for her to continue. "Who do you hate?" "Bailey. I was charting all the time. She made me charting all the time. And you've gotten a great cardio case."

"I did." answered Meredith."But Bailey's on warpath with me."

Cristina shot her a distinct look. Nobody but Meredith noticed that look. "I am fine." She said once again. I am fine. Let's do this once. I am fine." She saw the skeptiscm written on Cristina's face and Cristina's eyes said that she didn't believe her. "You said this word so many times today that it doesn't even sound like a word anymore." Cristina told her bluntly. "You look like crap." Alex said to Meredith, he agreed with Cristina. "So do you." Meredith gave back. So, now there're five people that basically had told her she looked not healthy.

"Not possible." Alex replied, smirking. Meredith huffed.

"You see, she got a great case, you are delivering babies and Barbie, what are you doing?" Cristina's topic was about surgery.

"I´m with Shepherd, I have watched a craniotomy, which was quite interesting." Izzie replied perkily with unnatural perkiness. "Ya see, and all I _am _doing is freaking charting. So, yes, I hate it." Cristina grumbled. "Uhuh, the great, great Cristina is charting." Izzie started making fun of her, causing Alex to end up laughing. Meredith started eating her meal, enjoying this for the first time in eight hours. While she was eating, she was listening to her friends' conversation.

"Shut up, barbie. Nobody asked for your opinion." Cristina snapped at the blonde.

"I have to go. I have better things to do than losing brain cells by listening to your crap." Then Cristina grabbed her coffee cup and disappeared. Meredith watched her go. She had to tell her. She had to. She just had to tell. There was no other way. If she collapsed, for example, and no one knows about her heart defect, it could be very dangerous for her. It could be enough to kill her, to stop her heart. Meredith decided to talk to Cristina. She left the Cafeteria without any explanation. Izzie called her name, but she ignored her.

"Meredith." Izzie's calling her name.

But Meredith willingly decided to ignore her.

"Meredith, wait. Where are you going?" Izzie's penetrant voice still could be heard but Meredith just walked away. "What is she doing?" She turned to George and Alex but they had no idea. But they all agreed that Meredith Grey was in fact acting weird. "I have absolutely no idea." George O'Malley replied honestly. "Me neither." Alex echoed George. "But there is something …" Izzie Stevens started. "You're being paranoid." George interjected, calling her on her shit. "It's probably some McDreamy issue she and Cristina need to discuss. We don't need to butt in there." Alex told her, trying to get her focus off of Meredith and Cristina talking about something Izzie did not need to know anyways. "Maybe, maybe it's not." Izzie replied and continued eating her meal.

* * *

Meredith walked down to the tunnels. She paged Cristina down to the tunnels under a pretext. She was waiting for her where the interns hide. "Come on, answer your page. You said you'd be available if I wanted to talk and now I do, I changed my mind." Meredith said into nothingness. Then she heard footsteps nearing. "Cristina?" She asked. "Yeah, that's me." A voice answered gruffly. A small shine of sunlight came through the window, lighting up Cristina's features. "Meredith, why'd you page me here?" She questioned as the realization hit. Cristina. I..." Meredith began after Cristina had answered her pager call. "I... gotta need to talk to you." Meredith slowly confessed. Cristina frowned. Meredith had changed her mind about telling her. "What's wrong?" She asked, crossing her arms over her chest. Meredith inhaled and exhaled deeply.

"Do you want me now tell you what your problem is? Don't think I forgot about the cyanosis. I have not. It is not something you easily forget. So, will you tell me about your medical problem? Should I say finally? Or is it Shepherd, if he is I am gonna kill him for hurting you again. Has it anything to do with McDreamy? Is he back to being McAss?" Cristina added slightly acidic, so Meredith rolled her eyes and exhaled audibly. "No this is not about Derek." Meredith shook her head. This wasn't about Derek. Derek was all supportive, even though he didn't know about it. Nobody knew until now. She was going to tell Cristina. That was her strategy of starting to tell people. Cristina always came first. Cristina tilted her head as she eyed Meredith suspiciously.

"So he isn't being a McAss?" Cristina asked back. "No, he's not being an ass. Derek's gorgeous and such a good guy that sometimes I think that I don't deserve him. He doesn't deserve to have a girlfriend who's …"

"Didn't you say that this wasn't about McDreamy? Will you get to the point sometime?" Cristina asked irritated by Meredith's weird behavior.

"Yes, right. That. The point, right. I totally forgot." Meredith rambled and when that happens she has a hard time stopping, a terrified expression was covering her face. "Mer, stop rambling." Cristina stopped her somehow in a way only Cristina is able to. Cristina watched her friend's reaction, then Meredith's face complexion. She was pale, her lips slowly turned a bit blue.

"Meredith, just tell me. Please. I won't tell anyone." Cristina begged.

Meredith breathed in, deeply before she said: "Okay, then let's get this show on the road." "This was inappropriate, Meredith." Cristina reminded her firmly. "Yeah, right." Meredith fumbled with her pager nervously. "Would you please leave your pager alone and tell me what's on your mind right now?" Cristina seemed determined to get the truth out of her. Then Meredith said sharply, "Not a word, okay? Do not repeat a_ single _word, okay? Do not breathe a single friggin' word of this to the outside. Not a single word to anyone. You cannot tell anyone. Not in any case Derek nor Burke. Same goes for Dr. Bailey. Just you can know about the thing I am about to tell you ..." Meredith told her, her voice nearly quivering. Cristina frowned and looked at her worriedly. She was worried. Concerned about what could be wrong with her friend. Not just friend, her person. The person that was like her sister because that's what they were, even if they aren't related by blood, they were as good as. They were as close as sisters. Blood didn't matter. Cristina was the family she chose. Cristina breathed in, her pulse was elevating due to stress.

"Okay. And why am I supposed to keep this a secret?" Cristina looked at her expectantly, slight impatience was on her face. Meredith pulled herself together, glanced at the ceiling and looked back at Cristina. "I am driving this train, Cristina, not you. And you've got to respect that." Cristina held up her hands. "Fine, slow down, we'll have it your way." Cristina assured her in a soft but reassuring voice that Meredith listened to. "Now that we've established that I won't say anything can we please get to the root of this?" She begged.

"Okay." She said slowly and hesitantly.

"What do you mean, okay." Cristina interrupted her. Meredith did not answer, instead she rummaged through her coat pocket. Slowly she moved the ultrasound image shows, took a quick glance at it and gave it without a word further to Cristina who hasn't looked at it yet. But when she will, she'll be denying this. She will be, for sure. Cristina stared at her in disbelief and asked: "Are you ..." She burst out laughing, while Meredith looked at her reproachfully, "...pregnant from McDreamy?"

Meredith hadn't expected this, she really hadn't but Cristina hasn't looked at the ultrasound image. If she did, her reaction would have been way different. That was one way to put it.

She could not suppress the question. She had to ask. Meredith's thoughts raced. Cristina can't be right. It just wasn't possible. She wasn't. Derek and she practically always used condom when having sex. Meredith knew how important that was, she was a doctor after all, she knew those things. Of course she wasn't. They always have used protection. They were like a condom ad. Also, this wasn't about pregnancy, this was about her heart.

"No, I am not." Meredith answered sternly, looking at the walls, slowly turning her face to Cristina, facing the Korean doctor. "So, there is not a chance that there is a little McDreamy about to come into the world? No baby, right?" Cristina bluntly asked, she had no problems asking that. "There is no baby. I am not even sure my body will be able to handle the whole two hearts in one body - thing." Meredith replied resignedly, secretly wishing she and Derek would be able to have kids when the time is right. "Wish I were." She mumbled to herself. Cristina heard the last sentence and felt the resignation in Meredith's voice. It almost sounded like she'd completely given up or thought about giving up.

It's been a long, devastating road with a lot of hurdles to cross.

Now Cristina was confused and stopped laughing.

Something about Meredith's voice told her that something was not right at all. At all. When she couldn't carry a child then what the heck is going on with her? Is it her heart or is it gynie - related? When it is heart related then it is most likely a heart defect. Some heart defects aren't ... can't be combined with pregnancy. Cristina's face turned into a caring frown. No, she inwardly screamed. This is just an imagination of my sleep-deprived, overtired and overworked brain induced by some neurotransmitters and neurons that have fired some weird signals. But apparently, this horror, absolute horror imagination has become reality.

It could kill a woman if it's Hypoplastic Left Heart Syndrome or Tricuspid Atresia or anything that needs to be palliated after the Fontan procedure. Or if the hemodynamic isn't like it should be. Cristina was normal in that way. She could carry through with a pregnancy. But Meredith?! Eisenmenger's is also a risk factor for complications that could arise during pregnancy - aortic aneurysms, heart failure, syncope's, brain abscess, formation of thrombosis and emboli; she could throw a clot that travels to her pulmonary arteries, increase of cyanosis, arrhythmias etc. There can also be certain risks to the unborn child. There are all tons of risks to the mother _and_ to the child.

Nervously, she studied her person's ultrasound picture more closely. She gasped in shock as she saw what was on it. It wasn't an embryo, it was a heart. A little, tiny heart. A tiny, little malformed heart. Cristina was not sure what to say. This was not the reality. She'd suspected it, yeah but she hadn't thought it was real. Meredith's name was on it. The patients name was on it. Patient: _Grey, Meredith**.**_ It was Meredith's ultrasound picture of her _heart_. Then she realized with a tremendous fear that this is not a picture of an Embryo. "This is no embryo." she said firmly as she put the pieces together, her voice trembling slightly. "It's a heart, a heart in the four-chamber view. I see a baby's heart. Where did you get the photograph?" Cristina stammered helplessly.

Meredith swallowed bile rising up in her throat, but conjured up now to not back down. She was nervous. She was nervous about what Cristina might say. To her. Why she did not say anything earlier? She knows why. Shocked, Cristina turned the ultrasound image, as she thought, whose picture it could be - Meredith. Of course, she had seen the letters on the front, there were small but Cristina read them anyway. Meredith Grey. Meredith Grey. The name sounded in her ears as she stared on the picture too shocked to react or say or do anything at all. Meredith, her person had been born with a life-threatening heart condition.

"No, it is not. It is no embryo. It is a sonograph of my heart at the age of six days." Meredith said with a strong voice. She looked Cristina right in the eyes. Shock could be read in the Korean doctor's face. She hoped Cristina would stay and not run for the hills. "I ..." Cristina began a sentence but did not really know what to say. She paled when she heard those shocking words as they hit her with full force. She was speechless.

Finally she was no longer alone. Not alone but with Cristina who now knew about it. She had Cristina. You could trust her. She is trustworthy. She would help her. She would, right? She would. No question about it.

"You …? This is your heart? Oh my..." Cristina's voice broke, shaken.

"This is your heart?" She asked after she had pulled herself together. Cristina's voice was toneless, emotionless. Cristina pushed her emotions aside to be there for her friend. But her face told Meredith that she cared. She was paler than before. Meredith could read shock and surprise on her face. "These are your images?" She repeated, looking at Meredith for a few seconds just to confirm it. Meredith hid her face in her hands. She did not have to say anything. She just looked at the ground. "But that's..." Cristina recognized and shook her head.

"... A Double Outlet Right Ventricle with associated interrupted aortic arch. Oh, Mer. You do have major cardiac Thing going on." Cristina trailed off … she went over to Mer and sat down next to her on the gurney. Awkwardly, she patted her hand. Meredith appreciated the nice gesture.

Meredith nodded.

"Guess I have." She said, taking Cristina's words in her mouth.

Cristina didn't blame her for not saying anything. If she was honest, she wouldn't either. But Burke was a heart surgeon. If it was her, for sure he would have noticed.

"What about the details?" Cristina asked after a moment of silence. Both of them seemed a bit off.

"Now it's out. Double Outlet Right Ventricle with TGA- type and sub pulmonic ventricular septal defect and in combination to that, I have been born with an interrupted aortic arch and then I also had been born with an Atrioventricular Septal Defect. Plus with five years I had a right ventricle outflow tract obstruction. My diagnosis is a complex condition called Taussig-Bing-Anomaly with AVCD." Meredith confirmed finally.

Cristina was silent. She had to think.

Meredith let her have the time to process what she just heard. She knew from experience that that was a lot digest, even for Cristina, hardcore cardio-loving intern.

Mer has a heart defect. That is a fact. There was no point in denying something that couldn't be denied. It was a fact. Meredith Grey, the daughter of the infamous Ellis Grey, had been born with a severe cardiac condition. Tell me about things you don't see coming- this is the thing I have never seen coming. If I had been a better friend, I would have noticed it earlier. That she wasn't, you know, as healthy as we are.

As I _am_.

As Derek _is_.

As George, Izzie and Alex _are_. Cristina's thoughts raced. "That is a lot, you have had at least two open- heart surgeries, am I correct in this assumption?" Cristina suspected. Her voice was trembling a bit but only a little bit. She looked at Meredith, waiting for an answer.

"Three." Meredith corrected with a heavy sigh.

"What? Why three?" Cristina worriedly exclaimed, panic shook in her voice, because she spent a lot of time in cardiothoracics and has boyfriend, who is a cardiac surgeon, so she knows that that could mean that Meredith's heart could be univentricular, that she has only one functioning chamber. A normal heart is biventricular, meaning it has two functioning main chambers called ventricles. But in some cases one of the ventricles is underdeveloped and too small, so the surgeons have to operate in three stages. The first stage is Norwood-I procedure, then Norwood-II, Hemifotan or Glenn procedure and the final surgery to separate the circulation is called Fontan procedure or TCPC.

_Three_. "You have had three surgeries to correct the underlying defects." She repeated, her voice quivering slightly. "Not correct the defects." She answered silently, after contemplating what to say and more importantly, how to say it.

"It wasn't corrective?" Cristina's panic increased with every passing second.

Meredith noticed that little detail.

"Is your left or right ventricle hypoplastic? Did they do a total cavo-pulmonary Connection?" She exclaimed, startled. Meredith's face fell. "No." She answered. Cristina breathed in, relieved. That would have changed everything if she had said yes. "Why would you think that?" She finally asked, as she has found her voice. Cristina looked at Meredith, she felt relieved. But only a little bit. Fontan or no Fontan-that did not change anything.

Meredith still had been born with a severe heart condition, a complex one with that. It was a CHD. Not only one but combined with other cardiac defects. Wait.

What about extra cardiac anomalies? Why didn't she think of that?

"No, they did not do a Fontan procedure. They have done a Yasui-surgery, because my aorta was hypoplastic, it was just too small to do something different, three months later I had the final surgery as in atrial switch operation." Meredith told Cristina. "Thank God, it wasn't a Fontan. That would mean your ven ..." "... my ventricle is hypoplastic and not able to pump the amount of blood through my body or to my lungs. It's dependent on the fact which ventricle is the one that's hypoplastic." Cristina nodded.

She sat quietly next to her and tried to realize what just happened.

Suddenly she asked: "Is it just your heart or are there any other problems you might wanna tell me about." Searchingly, she looked at her person. "What other problems?" Meredith played dumb. "Oh, come on, Meredith." Cristina exclaimed loudly. "Don't play dumb. You know exactly what I am talking about." "Sssh, don't be so loud, you're making way too much noise." Meredith said.

"As if others could hear us." She said ironically.

"If they do I am screwed. I lied." Meredith confessed, keeping her head down in shame.

"To whom? To whom did you lie to?" Cristina wanted to know.

"Bailey. She noticed something and then she confronted me and I had no other choice than that." Meredith sighed, knowing Cristina would get her like no one else does. "For starters, you could have told her the truth." Cristina pointed out. "Thanks for your input really. But I couldn't do that." Meredith answered, she was looking up and eyed Cristina for a moment. "Why?" Cristina questioned. "I wanted you to be the first to know." Meredith said quietly. Cristina had tears in her eyes, only now she learned how much her friend really trusted her.

"You are my person." Meredith said.

"I am?"

"You are."

Pause between the two sisters, even if they aren't related by blood.

"Even after this?"

Meredith was scared, scared of her answer.

"Even after this. I'll be damned if I'd let go through this without the support of your person. You should have at least one person you can go to whenever you need it."

Meredith hinted a small smile.

"I don't want to be a burden, you know." She said, hesitantly.

"Meredith Grey, what have just heard?" Cristina exclaimed, she knew her friend had tons of McIssues but that she thought she was a burden, that the hospital wouldn't be losing anything if she was gone – she hadn't expected this. "Meredith." Cristina said her name firmly, gently lifting her chin so that she was looking straight at her.

"You are not a burden, not to me and not to anyone in this hospital." Cristina assured her.

"How can you be sure?"

"You're funny, caring, you are a lot of things but you are not a burden."

A small chuckle escaped her lips.

"Thanks, I guess I needed that." "Damn right you are."

"I have no extra cardiac anomalies, if you want to know." Meredith said, becoming serious again, looking at the wall. "You haven't? No intestinal abnormalities, blood abnormalities, brain things or other neurological disorders I don't know about?" Cristina asked, wanting to make sure she got all the correct information. The kind of information she needed in case something happens and Meredith isn't able to make sound decisions about her medical care which can totally happen.

Meredith nodded.

"Good. That is good."

Then, after some silence, Cristina asked the one question Meredith was afraid of: "Mer. Why didn´t you tell me? Why did you wait so long before telling me? I could´ve helped you." She asked shocked.

"I ... didn't want anybody to know, I wanted to leave my past behind me. I know I am selfish, I really now that. But if you had known that from the beginning ..." Meredith tried to explain. "... We would have thought you only got a place in this hospital because of your mother and that thing." Meredith snickered as she heard Cristina's blunt remark that was just so damn true. "I knew you'd understand me." "Uh uh." Cristina tried to wrap her mind about the things she just heard.

"But you know, Bailey isn't the kind of person who lets you go the easy way." Cristina added. "You wouldn't have been treated than any of us with the difference that your health wouldn't have been compromised. This woman wouldn't give you the easy way. She's fair, trust me on that."

"I'll tell her when I am ready, eventually I have to." Meredith said dryly, reluctance could be heard in her voice. "Good girl. But do it soon, you should let …" But Cristina couldn't end her sentence before getting cut off by Mer. "No." Meredith said harshly, emotions were in overflow.

"Stupid." Cristina murmured softly.

"Stupid, stupid and stupid." She exclaimed a bit louder.

"Wait, did you just call me stupid?" Meredith interjected. "Well, yeah you deserved it." Cristina stated. "Maybe you're right …" "Not maybe, I am."

"Wait, you said atrial Switch operation. Does that mean your right ventricle is functioning as your system ventricle and pumps blood through the body?" Meredith confirmed this. "Yes, that's right. My right ventricle is doing the work the left was supposed to do."

Cristina was trying to wrap her mind around that piece of information.

"Oh man, normally the left ventricle pumps blood through the Body. Why haven't they performed an ASO? In cases like yours they usually perform an Arterial Switch Operation." Cristina said, wondering why they had not done it. "Because of the complex relationships of the vessels this was not an option." Meredith said quickly.

For some minutes no one of the two said anything. Then suddenly Meredith said one thing that shocked Cristina, if not even more as the other Information. "And I am ... well. I'm staged _NYHA II_." "What?" Cristina questioned shocked. "New York Heart Association Classification of heart failure." Meredith replied, knowing Cristina knew what this means and she´d just needed it confirmed. "I know what NYHA means. You are already at stage II?" She asked. Meredith nodded. "Does that mean you are cardiac insufficient?" Meredith sighed. "What do you think it means?" She finally replied. "So that means yes." Cristina said, with a slight trembling in her voice. Silence. Meredith stared at the ground.

"You should ..." Cristina finally pleaded.

"No," objected Meredith as soon as Cristina started the sentence. "I will not ..." She protested. "You are not okay. Mer, do you think I've forgotten what was yesterday? Dyspnea, cyanosis. Meredith, let somebody examine you." Cristina tried her very best to persuade the assistant doctor. "When was your last cardiac echo?" She asked sharply. Meredith didn´t answer. That was answer enough. "That's what I thought." She then said. Meredith knew what she meant.

Suddenly they heard voices. Izzie. George. Alex. They were coming down here. "Did you hear that?" Meredith asked tensely. Cristina nodded. "We better disappear." She said. "If we don't want them to know we should leave now." Meredith nodded and both women left tunnels. Meredith breathed heavily as they were in the hallways of the hospital, they reached an on-call room. That were the only rooms with a lock and that's exactly what they needed.

"Are you okay?" She asked.

Meredith breathed in, out, in. Her breaths came out rapid and shallow. Cristina grabbed her wrist and felt for her pulse. "Cristina. What are you doing." Meredith exclaimed, even if she knew what Cristina did. "I am feeling your pulse." She answered bluntly. "But not in the hallways, are you freaking crazy." Meredith wanted to free her wrist from Cristina's grip. But the Korean doctor was stronger than she thought. And so, she didn't get her wrist free.

"If not here, then in another hospital, or I can do it." Cristina offered trying to be helpful. Meredith sat leaning against the wall on the bed, Cristina walked restlessly up and down in front of her, even though the room was tiny. They were in an on-call room because on- call rooms are the only rooms that be locked despite the offices of the attending's, so nobody could disturb them. "And what will you do now?" Cristina asked after a while. "I really do not know." Meredith replied honestly. "You know, this is completely crazy." Suddenly she began to laugh. Meredith just watched her person. "I mean, that's completely surreal." "Yes, that's right. It's different. I feel better since you know it." Meredith said hesitantly and looked at Cristina openly.

"Please, don't leave me. You're the best friend I ever had. I know I haven't been much of a friend to you with the not telling things that matter but please, I am begging you to stay ..." Meredith suddenly said, looking at Cristina. Cristina stared at her and couldn't help but thinking: Why the hell could she possibly be thinking that I am gonna let her go through all of this crap alone?! Hello? That is so not gonna happen. She is my Person and she will be.

"What are you thinking? You're my person."

On Meredith's face the slight hint of a smile was seen.

"Does anybody know?" Cristina asked. Meredith shook her head. "No, of course not. You're the only one who knows. And Ellis had never talked with Dr. Webber about it. He does not know..." "Okay. Just so I understand correctly, no one knows? None? Not even McDreamy?" The last sounded surprised. Meredith rolled her eyes, because she really did not want to confirm what she tried to explain. "No, Derek does not know. And it will remain so please, okay? I really don't want the whole hospital to know about my medical history."

"But ... but you cannot keep it a secret forever. What if something happens and the others do not know?" Cristina tries to convey, she was incredibly worried. Meredith only replied: "You're my emergency contact, they are going to page you if something is not right. Moreover, it is noted in my file." Cristina exhaled in relief. "So I am your proxy." She stated. Meredith nodded. "Of course you are, who else would it be?" She asked. "You're the only one who knows the truth." Suddenly Meredith stood up and said: "I have to go, end of shift."

"We never get out on time." Cristina said. "I'm going to Dr. Bailey and ask her if I still need to get things done before I go. Then I am going home, because I am tired and exhausted, so yes, damn right you are. I will go home." Meredith sighed and opened the door. "Do not tell anybody." Meredith said. So Meredith Grey stepped into the hallway.

Cristina Yang was shocked and looked at her friend with open mouth afterwards.

She had expected anything else. Maybe she was pregnant or McDreamy was driving her crazy, but... She certainly didn´t expect this. "I have told you, because you're my person, Cristina." Cristina saw her friend just to, then she tried to smile and took a step toward her person. "Thank you for telling me. Thank you for being honest with me." Cristina pulled her person into a hug. They never do this, except occasionally …

Then she hugged Meredith, despite the fact that she and Meredith normally don't do hugs. But this was a complete different situation. She and Meredith both needed the support. "You realize what we´re going to do, right, Mer." Cristina suddenly said and got up. "Oh no, you cannot do that. You're an intern." Meredith half-heartedly protested. "And so are you. I am kicking ass at performing an cardiac ECHO. Burke taught me everything I need to know and since you wouldn't let Burke do it..." She paused point out the idiocy of that, but she continued the sentence.

"I am the one who will be performing your echocardiography. Or do you want me to page Burke or maybe Derek." She threatened Meredith. She did not like the ultimatum but she kinda had no choice, Meredith did not give her a choice but to do this. It was for Meredith's own good. "Shut up. You wouldn't dare." Meredith simply retorted. "Don't test me, Meredith. I love you and all but I am serious about this. Downright serious which means you won't be getting away without an ECHO." "Okay, then get the hell up or I am gonna kick your ass all the way to an exam room." Cristina ordered. Meredith didn't even try to protest, knowing she hadn't a chance. If Cristina wanted something like that.

Meredith stood up slowly to let her circulatory system have the time it needs to adjust to the change and followed Cristina to an examination room to get heart examined. She knew she was in moderate, yet stabilized heart failure. She knew the symptoms and she knew it would worsen. She was not sure if she really wanted to know what was going on. Because one thing was obvious:

Something is definitely not correct.

Her symptoms had worsened very much recently. Maybe it was her aortic valve or her atrial tunnel caused Problems, there were tons of possible outcomes: baffle leaks, LVOTO or arrhythmia, or much worse, her right ventricle would slowly but surely _fail _in the near time. And if she really needed surgery, there would be scar tissue, which complicates the entire situation. Her mind was racing as she freed her upper body and lay down in-side position on the table, so it won´t cause interposition of the lungs.

"Are you ready? Can I start?" Cristina asked as she flipped on the machine and reached for the transducer. "Mer?" She asked as she did not get an answer.

Meredith simply stared at the ceiling and didn't respond in any way. Cristina shrugged and started with the apical four-chamber view. She placed transducer on the fifth intercostal space, aproximately left midclavicular. The transducer's index mark is directed towards the patient's left side. Her left (LV) and her right ventricle (RV), as well as the left (LA) and the right atrium (RA) were displayed on the screen. It was a heart. A real heart that was beating in front of her, and more importantly it was her friend's heart. Her friend who chose to ignore and deny the extent of her situation. Cristina studied the screen thoroughly. Cristina could not believe that she really had Mer's heart on the monitor.

Meredith could hear the faint 'whoosh whoosh' in the room. She knew it was the sound of the valves as Cristina looked at them switching into M-Mode. This view is used to measure the width of the aortic root, the separation of the aortic cusps, and the anteroposterior dimension of the left atrium. The M-Mode can be performed from a long or a short axis view. Whichever view Cristina used, she made sure that she aligned the structures perpendicular to the M-Mode. This is done by adjusting the 2D image plane as well as the M-Mode line. She also scanned all the other valves using the M-Mode technique. "Already found something pathologic?" Meredith said pessimistic.

"Just shut up and let me do my freaking job." Cristina hissed, unnerved by the whole situation.

It just freaks her out.

"Calm down, I'll be quiet." Meredith groaned. "Is that what you understand quiet means?" Cristina asked as she shook her head at Meredith's stubbornness. Otherwise all was quiet. No one said a word, neither Mer nor Cristina. Then she turned the transducer approx. 60° counterclockwise from the previous position. The left ventricle (LV) and the left atrium (LA) are shown on the monitor. Cristina took a deep breath as she moved the transducer to next position. It was definitely easier to do this on some random patient than on the best friend she has ever had.

Cristina was highly concentrated and at first he looked at the heart in the apical four-chamber view. The transducer is placed above the apex also known as apex cordis. The nose of the transducer is pointing laterally, also to the left shoulder. The scan view runs towards the heart base. Thus, the left ventricle is right-sided. The transducer is tilted by Dr. Yang anteriorly toward the aorta thus also tilts to scan view. Now the beginning of the aorta ascendes, left ventricular outflow tract and aortic valve represented. Cristina Yang has had Meredith's heart echoed in the apical five-chamber view. She enlarged and reduced the image to get a better view to see if something is wrong. Highly concentrated, she stared silently at the screen, the transducer not moving. "Damn it." She murmured softly. She measured something with a line to see how large the hole in the interventricular septum is. She sighed loudly.

"What happened?" Meredith asked, whose voice sounded extremely tense.

"It ..." Cristina faltered, she was hesitant, but knew she had to ask questions about her condition and medical history. It may be very important. "Was there a residual defect, Mer? It is important that you are honest to me." Cristina pressed a few buttons so that the image freezes and she could walk over to face Meredith who did not answer right away. "Mer? Residual defects, are there any bells ringing?" Cristina called her name.

Meredith swallowed.

Yes, Cristina was right; actually there is a residual VSD. They had not been able to close the ventricular septal defect completely. Following to that there was a constant left-to-right shunt which can lead to pulmonary hypertension or even worse Eisenmenger's reaction if not treated.

"Mer?" Cristina asked.

"I'd really appreciate some answers, Mer. Even more, since I know you haven't gone to Check- ups in _three_ years. Three damn years. That is irresponsible. You were a med student and should have known better." She was aware that this wasn't the right time to place blame but she just couldn't help it. This irresponsible action could have ended differently.

"Cristina, just stop it." Meredith interrupted, sounding a bit angry.

"I wanted to leave my past behind and didn't want to be reminded by getting a cardiac check-up every damn year? When was your first echo, Cris? Tell me when. I assume you never even had one, hadn´t you? As for your question, there is a residual VSD." Meredith hissed. Cristina didn't reply, instead she tried to get a better view of her aortic valve, registering the stenosis and the narrow valve. Aortic valve stenosis. Meredith could pass out under stress, because her heart could not pump enough blood through her body in time. Damn it. It was worse than she thought.

Maybe she should page Dr. Preston Burke so he could take a look. She pondered it for a moment, well, Mer would kill her for even thinking 'bout it … She removed the transducer from Meredith's chest after she saw her heart in all possible scan views: Subcostal four-chamber view, Parasternal short axis (aortic valve level), suprasternal view, Subcostal view, Apical two-chamber view, Apical three-chamber view, Parasternal short axis (mitral valve level), Parasternal short axis (papillary muscle level), Parasternal short axis (apical level), Parasternal long axis - that were the Two-dimensional views. After she also completed the Standard measures with M-mode. It is a Time-Motion method and happened to representation of the Echo of a continuous Time. There are precise measurements of the end-diastolic and end-systolic strength of septum and Posterior wall, end-diastolic and end-systolic ventricle diameter possible. The left ventricular function can be calculated too.

"I need to page Dr. Burke right away, Meredith." Cristina decided.

Meredith suddenly sat up and directed the view to Cristina, her eyes blinked in confusion. "What, no." Meredith insisted. "You promised. Don't make me regret telling you. Please, don´t tell him anything." Meredith pleaded with big blue eyes. Cristina let out a deep sight. "You have an aortic stenosis, Mer. You need..." She inhaled deeply. Then exhaled. Then she continued to speak, again with this emotionless, weird voice that signaled unmistakably that something was undeniably wrong and terribly wrong.

"Your aortic valve is thickened and possibly calcified with decreased mobility. I am afraid you gonna need surgery, Mer." Cristina was the bearer of some very bad news.

"No no no no no. That has to be a mistake. I don't want to have surgery. I hate being the patient. I don´t want it anymore..." Meredith was on the verge of crying. Helpless she stared at the wall, she avoids Cristina´s gaze. "Mer?" Cristina was worried about Meredith. Meredith didn't know what she should do. It wasn't fair. This wasn't fair. Not for her anyways.

"Are you okay? Should I get Derek?" She didn't answer. She needs her to snap out of this, this isn't healthy …

Meredith showed signs of emotional shock. She couldn´t realize what was happening right now. She was in denial. Cristina didn´t know what to do next. Should she page Burke? She wanted to be here for her Person, to help her processing. "Mer. Everything´s gonna be okay." Cristina tried to comfort her. She was miserable at those things called emotions. She didn't do emotions. But now? "You don´t do that. Maybe I am gonna die. There is always a risk of dying in surgery, especially with my history. God, I can't believe this is happening." She rambled, for once Cristina felt totally helpless. Meredith just could not believe it.

Why does it always happen to her?

It wasn't fair at all. In all unfairness it has to happen to her of course. She was a lightning rod for those things. They always happen to her so why not now too? Let's just cut to the chase. It won't change anything anyways.

Oh, right, life is never fair, but I've already had three open heart surgeries.

I don´t want to lay on the operating open only to be cut open.

This damn aortic valve. Why can't it be easy for once in my damn life? Why does it always have to be so complicated? I do not want it anymore... God, life is so not fair, but I think I´ve already said this once.

_N_ow Meredith was sobbing uncontrollably and without saying anything Cristina hugged her Person for the second time on this day... She did not really care about that, though. All she cared about was Meredith. And her friend was in a very Dark and twisty place right now. And she could sympathize. This situation was not the best but she knew that Meredith needed her now more than anything. "Everything is going to be just fine. You won't die." Cristina soothed her like a child. "You don't know." Meredith knew the odds, her voice was shaking uncontrollably.

It was unlike Cristina but for her person she made that sacrifice of doing things she would never do.

"You will live, Meredith Grey. You are strong person and you will get through this."

* * *

**_A/N: Thank you for reading. I hope you enjoyed reading this... _**

**_Well, there was a lot medical jargon in this chapter, right? So, here are some explanations. Let´s start with the surgeries I´ve mentioned._**

**_First of, there is a procedure called `Atrial Switch Operation´. It is a complex procedure. The atrial septum was removed and an artificial conduit set on atrial redirection of the venous blood so that the oxygenated blood passes into the systemic circulation. Aorta and pulmonary artery remained on the "wrong" position. That means that, the right heart pumps the oxygenated blood into the aorta and with that into the system and the left heart pumps the venous blood back to the lungs. However, it must be expected with cardiac arrhythmias in the long run perhaps the tricuspid valve may be leaking and the right ventricle could fail due to the high pressures._**

**_Then there was a procedure called ´Arterial Switch Operation´. It's a procedure to correct Transposition of the Great Arteries (d-TGA). It is performed in the first days or weeks after birth. Aorta and pulmonary artery are briefly separated off above the heart valves and switched reattached. The coronary arteries must also be reattached correctly. An existing ventricular septal defect (VSD) is closed. The circulation now matches the anatomy. The children develop rather without complications and usually normal._**

**_Then I have mentioned the Fontan procedure. It is performed one of the ventricles is underdeveloped and too small, so the surgeons have to operate in three stages. The first stage is Norwood-I procedure, then Norwood-II, Hemifotan or Glenn procedure and the final surgery to separate the circulation is called Fontan procedure or TCPC. Hypoplastic Left Heart Syndrome (H.L.H.S.), Tricuspid Atresia (Hypoplastic Right Heart; TA), Double Inlet Left / Right Ventricle are heart defects where one ventricle is underdeveloped, so infants with this kind of defect need these surgeries in order to survive._**

**_Now, finally I am ready to explain Aortic Valve Stenosis. Aortic Valve Stenosis (AS) is a disease of the heart valves in which the opening of the aortic valve is narrowed. In aortic stenosis, the outflow of blood from the left ventricle becomes partially obstructed, and the heart has to work much harder to eject blood._**


	6. Chapter 6

**Chapter 6**

* * *

**When something begins, generally have no idea how it's going to end. The house you're going to sell becomes your home, the roommates you were forced to take in become your family and the one night stand you were determined to forget becomes the love of your life. We spend our whole lives worrying about the future, planning for the future, trying to predict the future, as if figuring it out will somehow cushion the blow. But the future is always changing. The future is the home of our deepest fears and wildest hopes. But one thing is certain when it finally reveals itself. The future is never the way we imagined it. **Meredith Grey; Here´s to Future Days

* * *

Time flies. Seconds become minutes, minutes become hours, hours become days... Surgeons make time fly. We never know what will happen in the future. And suddenly everything is different. It's maybe just one second, but this second can change your life dramatically.

Meredith just sat there. Trying to breathe. Trying desperately to understand what was happening to her. Again happening to her. She'd cried, but eventually stopped after a little while. Now she just sat there for like, ten minutes, without moving or talking. She seemed frozen. Complete frozen due to the shocking news she received. "Mer?" Cristina asked, but hey, surprise, no response. Meredith continued to stare against the wall, she didn't want to acknowledge the fact that she needed open heart surgery sometime soon. "Meredith." Cristina tried again. Meredith responded with a shrug, as if she didn't care. But Cristina knew that that was just an defense mechanism. Meredith didn't want to be weak, to show weakness and admitting that she needed medical attention ... That Meredith really needed that specific surgery to replace her aortic valve.

Suddenly the door opened without knocking first. Cristina flinched when she heard the door open. Then she reacted. "Meredith. Your ..." Meredith looked up, to Cristina then to the door. Which was half open. Which idiot opens a door in a hospital without knocking? Are only stupid brainless idiots working here ... Unbelievable. No bedside manner. Who was this idiot? Cristina yelped loudly: "Get out. Get out." But whoever this was, didn't listen to her. Meredith jolted awake, startled. Her heart rate accelerated when she heard the panic in Cristina's voice. "What is going on?" She whispered. "Turn around, put on your t- shirt. If she ..." Meredith quickly did what Cristina said, even if this ultrasonic gel was still covering her upper body. It wasn't very, well, comfortable but better than the alternative. "Whoever this is, get out. Get out. Now. This room is occupied." Cristina called out loud, while Meredith was too shocked to react in time.

But it was too late. Too late, whoever this was, had already opened the door. Meredith and Cristina were in full- on panic mode. Hopefully it wasn't Bailey or Burke. Because then, Meredith had no choice but telling them about her heart defect and how it was affecting her. (Now she was suffering from moderate aortic valve stenosis, but that is just one thing.) The door was already opened. By one of their colleagues. Not Dr. Bailey, or Burke. Izzie was standing in the doorway, eyeing Cristina and Meredith suspiciously. It was Izzie Stevens. Greatest gossip from the interns. She just did not know when it was the right thing to keep her mouth shut.

"What are you guys doin' ..." She asked curiously and her gaze wandered through the room, noticing the ultrasound machine with a picture of an organ frozen. Not any organ. It was a heart. Not any heart. It was not Cristina's heart. Her was healthy, it was Meredith's heart on the monitor but Izzie did not need to know that. It was not hers to know. Even if they were roommates, Meredith did not want her to know. If she knew the whole hospital would know within hours. Gossip travels fast.

"What the heck are you doing in an exam room?" Izzie asked, looking around. She noticed that only Meredith and Cristina were here. And tell ultrasound machine was switched on. The device was still on stand-by. Nobody answered. And Izzie did not expect them to answer. "We were practicing to perform an echo. Have you ever done one before, Iz?" Cristina questioned, she was trying to distract her. Meredith's heart was still on the screen, frozen in a moment. A single moment that can change everything. "Nope. I have not performed an echo on one of my friends, if that is what you mean. Can I ask why you are asking all these weird questions?" Izzie wanted to know. "It is none of your business." She stated bluntly.

Izzie looked at her with an angry face. "Can I ask you why it always only you and you in your little, I don't know, fan club? I am always on the outside. Meredith, why am I always on the outside. Why are you never telling me any of your little secrets?" Izzie asked. She was furious, for a long long time she had suppressed those feeling towards them but now she wasn't able of keeping her feelings in place. Cristina stared at the blonde with an unreadable face expression, while Meredith said: "Izzie. I know you are furious, but Cristina and I aren't a little fan club. Why did you say fan club? This makes no sense."

Izzie scoffed and rolled her eyes. "What?" Cristina came to help her person, to support her. Izzie wasn't about to give up now. She hated it that she was always left behind. She wanted to change that. Izzie noticed the tension in the room. The tension that was towards her.

"Is everything okay? Because you are acting weird, not to mention the fact you were practicing doing cardiac echoes. That´s a lie, isn´t it?" She really believed that she was right with her assumption. And she was, even if she won´t ever know about the fact that she had been right, 'cause it really is none of her business. She should mind her own business. She really should do that because interfering with things that does not concern her isn't exactly the best way to win friends.

Cristina's enough. Izzie interferes up in things that does not concern her. "Izzie, leave it and go. Now. And close the freaking door on your way out." Cristina uttered in a loud commanding voice. "But I ..." Izzie responded. "Get out. Leave it and go." Cristina commanded. Izzie did not know what that was supposed to be here. Meredith and Cristina, both in a freaking exam room, eager to get her out of her. They seem to have a secret. A 'In a Meredith and Cristina way'- secret. "You and your McSecrets are annoying. You know that, right?" Meredith shook her head.

"I don't know that, but does it concern you? No, it does not concern you." Meredith replied. "Would you please just go and leave us alone? Don't you have patients or work to do?" She asked the blonde doctor. "I do, actually but I can't ... I don't think the brain's that interesting." Meredith's thoughts raced. She was on Derek's service. Which meant she could tell him about what she saw. Oh, no this wasn't good. "Good, then go do your work. Meredith and I are off work. We are about heading to Joe's and drink some shots before going to bed." Cristina told her. Izzie did not move.

Her hand was still on the doorknob. She was not moving. Cristina's nerves were lying blank and Izzie overused her nerves even more. And she was sick about her not listening.

She was stubborn when it came to that. And it was annoying. Sometimes she could be nice, but there is always another side to coin. She could also be demon- like. "And don't tell Bailey about this. She doesn't need to know." Cristina commanded Izzie without having a choice to say no, to what Cristina wants her to do or not to do. "What know?" Izzie replied, her eyes were focused on Cristina. She couldn´t hold herself back and just had to ask this question. "I don't even know what you're talking about. I think it's your big secret. Whatever, you have Said something about practicing echoes? Can I join you? Just for fun." She wanted to test her reaction to that question.

Meredith threw Cristina a somewhat tortured and almost pleading look, which didn't go unnoticed by Izzie. "Do not tell." She mouthed towards Cristina who seemed to understand. Now Izzie was confused. Something was going on here and her colleagues were guaranteed not only here to practice performing cardiac echoes. And here was another thing: Cristina didn´t need to improve her echocardiography skills. She was a real talent, natural and Meredith, well she could do it without any problems as well. Well, she's got Ellis Grey as mother. Some people always have an easy life, and don't have to work their ass off to pay med school. But she didn't know that she has had it easier than Meredith.

Well, she was born healthy, her heart was strong and there were no abnormalities diagnosed when she was an infant. But Izzie Stevens did not know that. That her life had been easier than Meredith's, despite growing up in a trailer park in Chehalis and getting pregnant when she was still in school. She had a daughter, Hannah. She gave her up for adoption.

But she did not know what Meredith's life was like when she was a kid. Not easy was it for her, so much was clear. At least it was for Cristina. Not for Izzie, George or Alex. Bailey and Burke were assuming that something wasn't like it should be but nobody than Cristina and Meredith knew about Meredith's thing.

Something was off on this little situation here. Impatiently she waited for an answer from either of them.

"Can I join you?" She repeated.

"I have to go." Meredith interjected and hurried out without saying another word. "Meredith, why are you going? You are walking away again." "Let her go." Cristina responded harshly. "When she doesn't want to talk to you, it is your problem, but let her go. If she wants to talk to you, she will let you know but don't try to tell her what she should do or not do. You are not her mother." Cristina left, too. Izzie was standing in the hallway. Her mind was racing. She recalled their strange, weird behavior in the exam room. That was funny, especially strange Mer had behaved. She looked around in the room. She wondered whether it was right to do that what she wanted to do. Probably not. Cristina was right. It was confidential information after all. Izzie made sure that she had not been seen by someone and then sat in front of the monitor. She did not immediately recognize what it was. A heart, yes. That was obvious. But then she realized it must have been Meredith's heart or Cristina's heart.

She was focused on looking those pictures and did not hear that the door opened and Cristina was standing there. Stunned, how brazenly and outrageous Izzie was and really went back to see what was on the pictures, Cristina was angry. How could she do this, how could she? That is ... She did not know what this was.

"What the heck are you doing? This is private. That's confidential information. You freaking unbelievable." Cristina burst out and continued: "Get out. Now. Forget what you have seen. It is none of your business. What the hell were you thinking? Don't you know the friggin' meaning of the 'private'? It´s confidential information. If you tell anybody about what you've seen in here I am going to kick your little ass back to Chehalis. You get it, right?" Izzie didn´t know what to reply. She remained quiet. Cristina immediately saved the cardiac images (named Jane Doe, of course) and then she shut down the device until further notice. Izzie was standing there like a complete idiot.

* * *

Without a word she left the room and went home after a long and devastating 48 hour shift. At Burke's apartment, Cristina was alone. Burke was still at the hospital. He was operating on a car crash victim who had a hole in his heart, that was caused by the accident. He was tamponading when Cristina begged Burke to scrub in on this one. But he had said: "No, Yang. Go home. Your shift is finished, you don't need to be here." She had protested of course, but Burke had been stubborn as well. So she was home early. Meredith also had been on her way home. But unlike her boyfriend, Derek had been leaving when she left. She had seen him when she went to her car.

Cristina unlocked the door of Burke's apartment. Carelessly she threw her bag in the corner and ran into the kitchen. She switched on the coffee machine and waited impatiently for the coffee get ready. This day had been a total disaster. But the crowning glory had been Meredith or even better, her secret. And that had been more than shocking. Cristina still could not quite believe what she was told. And Izzie was just ... how could she? It was confidential information. It wasn't her to do. Cristina tried to get her mind off of these things ... But it was harder than she thought it would be.

_Mer has heart condition?!_

_This is a freaking joke, a freaking bad joke..._

_But then, reality really has the intention to bite you in the ass..._

_And you realize that the things you fear the most suddenly became reality..._

_And you are helpless, can't do anything about it to make the world stop crumbling around you ...  
_

_Everything seems to be moving around you ..._

Cristina shook her head, she still couldn't believe it, although she'd seen it on the monitor when she did the echo. That could not be true. That had to be a mistake, it just had to ... No one knew it. No one. Only her. She knew it as only one. Even Derek did not know. God, that was a _**huge** _responsibility. "Finally." Cristina muttered irritably and reached for the steaming coffee cup and placed it carelessly on the table. Then she raided Burke's reference books for information about the interrupted aortic arch, the Double Outlet Right Ventricle and the right ventricular outflow tract obstruction.

She needed more information about these conditions now that she was Meredith's health proxy if anything had happened to her and she wouldn´t be able to make decisions for her own. So she needed to know what that means for the patient that was born with that kind of heart condition. She knew there were others out there with even more severe heart defects and arrhythmias with pacemaker indication but it was shocking, she still could not believe it. Although she vaguely knew what it meant, but now? Things had changed. From one other time everything has changed. Out of nowhere. She let the interview with Meredith pass in revue.

_Why the hell she didn´t want to tell Derek?_ Cristina understood.

She did not know if she would tell Burke if she were in Meredith's position. He was a heart surgeon and knew what this meant. For her. But that were all maybes, no definites.

_Okay, not really. Maybe she fears that he would leave her, but if he does... __h__e´s isn´t the one. He isn´t worth it then._

But she should tell him. She should tell him, Derek. He deserved it. He was a good man, even if he hadn't told her about McWife. Addison, his ex wife who suddenly appeared out of nowhere. Meredith did not know Derek was married. Was. He isn't anymore, he divorced Addison after they tried and failed. For her own good. Feverishly she rummaged through Preston's medical books, which he had sorted the shelf by Release Date. Wow, Cristina thought. When she had finally found, she reached for the books, positioned the stack of medical books on the table and began to read frantically. She wanted to know everything. She quickly found what she was looking for.

Journals, articles and case studies about different heart defects and most important about patients with the kind of medical condition Meredith was born with. The things she read were hard to read. She was too close to this, she now knew why doctors should not treat family members. Because of this. This was the reason. They can't think clearly and aren't able to make rational decisions for their loved ones.

* * *

**Meredith, 12 years**

_Meredith understood her classmates just don´t. Since it was on the new school, everything had changed. It started on the first day of school, than any classmate by chance Meredith' secret, in the sense learned. Apparently they had a conversation between her and Sadie Harris overheard, which was at the time still her best friend ... "Have you time today, Mer?" Sadie asked, took a sip of her cocoa. She liked cocoa, it was sweet and warm. Her hands were always cold- due to poor circulation. One of the many curses of being born with a heart condition. Another curse was that making friends isn't very easy. Most of them can't take that, don't know how to react. _

_They think, it is contagious- which is wrong in so many ways but some people just don't understand it. 'Her only friend had been Sadie. And this korean girl that lived in the same street as her and her mother for like three years, then they suddenly were gone. Disappeared. Meredith never knew what exactly had happened. She had been nine years, the girl had the same age. The girl's mother always called her 'Crissy' but Meredith was told by Cristina (that was her real name) that she should call her Cristina. She hated nicknames like Crissy. They were girly._

_Meredith had laughed with her about that. She had the same opinion. Crissy sounded weird but she liked Cristina's real name. They met often but suddenly, Cristina was gone. They were moving away, somewhere to another place. West Coast. Not Seattle, but Los Angeles. Why they moved Meredith didn't know. She did not have an address to contact her friend. Even though Cristina is gone (She is in another city, not dead!) Meredith still considered her as her best friend. A real friend. She had even told her about her heart defect. Or at least, she mentioned it to her but Cristina shrugged and replied: "As long as you live, I don't care. I wanna be a doctor, you know." "My mother is one. A surgeon." Meredith said poudly. Cristina's eyes lightened up when Meredith said that.'  
_

_Sadie's voice brought her back to reality. All this was three years ago but she remembered every bit of it. "Hey, Mere. What is going on with you? You look distracted." "What, no. I am not." Meredith responded. "You are. Today, my place?" She asked again. Sadie wanted to meet with her. But Meredith had no time to meet with her friend. She had a doctors appointment. "Um ..." Meredith said, not quite to the point. "Have you time to come over to my place?" Sadie repeated her question, a little louder. Meredith shook her head. "No, I have the follow-up at the pediatric cardiologist today at 11:25 clock." She said then apologetically. Sadie seemed a bit disappointed but she unnderstood why it was important for her friend to go to regular check-ups to make sure everything's in the normal range.  
_

_"Oh, right, yes, you had told me. I've just forgotten." Sadie excused. "It is okay. It can get a bit confusing sometimes." Meredith said.  
_

_"Have you with the written excuse? From your mum, the teacher needs it." Sadie made sure, because otherwise Meredith would have problems. Because of unexcused absence and missing periods. "What do you think? Of course I have. I am not an idiot, I know the drill." Meredith laughed. After the English period with their class teacher Meredith walked to the teachers desk. Her school bag was packed and ready to go. "Meredith." The teacher said, astonished when she saw the girl walking towards her, unsure of herself. "Come on, Meredith. Just say what want. I don't have all day." Meredith flinched and was even more nervous. _

_"I just wanted to leave this excuse." Meredith murmured shyly and gave the teacher an envelope. The teacher frowned and opened the envelope. She silently read the excuse. __"Why is that, Meredith?" "I ... uh ... have a doctor's appointment." She finally said."At your health care provider's office, right?" She wanted to know. "To get my heart checked. Like every half year." Meredith answered. "Why don't you get it?" Meredith asked her teacher. "It is the same every every damn year. Why don't you get it that I have to go to get my heart checked? Why won't you get it?"_

_The teacher looked at her shocked. Meredith finally stood up for herself. Her class teacher did not expect that. "Meredith, I appreciate that you are finally stand up for yourself. But that was rude." The teacher told her. Meredith didn't answer, what should she answer. Nothing would change anyways. The teacher, Ms Gerrison, said: "Okay, it is okay for you to your appointment. And I will keep in mind what you said, I will inform the other teachers so that they know about your heart condition."_

_"Finally. That is a thing that you should have done the minute I told you, or my mother, told you about it. But good, that you finally get it. What a relief." Meredith responded. The teacher chose not to respond, maybe it was for the better. She knew Meredith's got a point. "Oh, Meri and her special rights again." Cried a boy in her class. Meredith gave him a furious look. She hated to be so in the Center of everything. "Quiet down please." The teacher exclaimed irritably in the class and then turned back to Meredith, who lost standing beside the teacher's desk. _

_"Now go, Meredith." The teacher gave her final 'okay'. After the teacher had said this, Meredith grabbed her school bag and left the class. Outside in the hallway, she stopped and took a deep breath. Somewhat she was relieved to skip School. Then she made her way outside, where Ellis Grey was waiting for her daughter._

* * *

"Cristina." Dr. Preston Burke's voice sounded through the apartment, and a few seconds later, the door slammed shut and Preston Burke stepped into the kitchen. Cristina looked up, startled, she had to give a funny picture. A fact she was Aware of. Preston looked around in his apartment. It is just ... wow ... how can a single person make that mess all alone? But Cristina didn't take notice of him, she was scribbling something on a pager in a unreadable handwriting. Some doctors really have horror handwritings... That is a given. She did not even look up when he called her by name. "Cristina Yang." He said loudly. "How is your patient." She asked back. "The MVC. You wouldn't let me scrub in." "Uhh, he is fine. In Cardiac Intensive Care Unit, attached to a mechanical vent but his sats and vital functions are good, as well as his urine output. He will probably make it through the night." He answered, a hint of a smile was covering his lips.

"Hm." Cristina made a sound Burke couldn't identify. Then she turned her attention back to the opened medical books, references et cetera. Mostly, they were about cardiac surgery, heart problems in children, adolescents and young adults. Which was weird but he did not say anything. He was pretty sure Cristina had her reasons for all of this. But he did npt know what a reason. What an alarming reason she had.

He cleared his throat, causing Cristina look up and notice his presence.

She finally looking up. "Oh, you´re home." She stated. He poured himself a cup of already cold coffee. Then he asked: "How about we watching television and maybe cuddle?" His voice was slightly unsure, Cristina wasn´t the romantic type of girl. He knew that. She was competitive, very competitive and wanted to be the first, no matter what. But she was a good friend to Meredith. "TV, really? And cuddling? Can´t you think of something more appealing?" Cristina commented ironically. Burke chuckled. The comment, that he expected.

She didn't look up from the medical articles and journals she was reading in. She felt like she was doing two or three things at the same time, and that was partly right and she didn't answer his question. Why would she? She wasn't a fan of romantic thingies. "We were talking about the cuddling." Preston tried to tell her. "No time, very sorry about that, though." She responded. The metallic clicking of her ballpoint pen could be heard. Otherwise it was perfectly quiet.

"Repeat that." He looked aghast, Cristina can be really, how do you say, harsh sometimes and lacks at communication. Then he sighed. "What should I repeat? The thing where I downplay the cuddle- thing or the cardiac patient you wouldn't let me scrub in on?" Burke sighed.

"I've got a thing to do." Cristina explained without looking up. "And this thing..." Preston began. "This so-called Thing..." He paused tentatively, then continued: "Does it involve Research about all possible congenital heart defects especially 'double chambered right ventricle' and 'interrupted aortic arch' and their different options of surgical repair or physiologically corrective procedures like Atrial Switch Operation, Rastelli procedure, Yasui procedure and their different outcomes and potential post-op complications? That´s..." Cristina's voice cut him off before he could end the sentence.

Cristina interrupted him. "Don´t complete this sentence. Just... just don´t."

"That´s just weird. Even for you. I know you are overly focused on cardio, but this extreme. You didn´t do that before. So, my question is why now and anyway, why are you doing this, all this non-work related research? That is weird." He said, trying to understand why she did this excessive research on cardiac procedures in infants or / and children.

"Burke, just stop it. It is none of your damn business, so go do something else. Not everything has to concern you. And this isn't something I want to talk about to you. I made a promise and I won't break it. But that is besides the point. I need this room to be quiet, I need to fucking concentrate and I definitely cannot do that with you hovering and questioning me what the heck I am doing. So go do something else, I don´t care what, just go do something else. Or Í am gonna explode. I can be a friggin' time bomb. Ok, Forget the last part." Cristina shook her head, nervously she waited for Prestons reaction.

"You sure, everything´s okay?"

"Everything is just fine." She exclaimed, throwing her ballpoint pen through the Apartment. "What are you doing, Cristina. This is not normal you. This is somebody else, not the Cristina I love. So tell me what happened. Is it Meredith?" He asked. Cristina supported her head with her Hands, she was on the verge of having some kind of nevous breakdown like she did have when she´d had the ectopic pregnancy and lost the baby because of it.

"Just go. Now. I need to be alone. I can´t deal with this right now."

"What..." Cristina did not answer. Preston Burke realized in the next second, that that were his books and journals. "What are you doing, Cristina?" He asked again. Cristina looked up and smiled, although she actually thought _'How did I get myself in this mess´._ This. Is. Not. Real.' Oh yes. It is. It is more than totally real, you cannot deny that. "Just some not work-related research about the combination of DORV and IAA." She said without paying attention. It slipped out of her, but not Preston did not paid attention. Luckily he didn't notice, if he did she'd be in so much trouble.

"Cristina. Grey is assisting on this case, you know?" Suspiciously eyed the world class heart surgeon his girlfriend, who looked like she wanted to disappear right away. "Mer?" Cristina's face changed in a split second of no emotion to shocked and almost surprised. "Meredith is assisting in a procedure in a patient with DORV? Oh my God, she's..." Cristina broke off scared. "She's what?" Preston asked with a hint of suspicion in his voice. Now it gets interesting.

_She couldn´t tell about Meredith's heart defects._

_Crap ... Damnit, she was so so screwed.  
_

Preston sighed. Cristina was just being Cristina. Cardio focused. Except, this time she wasn't- she was concerned about a friend, a close friend that was like he sister, her person. This was about friendship. It was more than work. "Okay, I will go clean this mess up." Cristina began carefully and cleaned up the table, which was a total mess. Everywhere flew slips of paper and markers around, medical books for professionals were laying opened on the table. Two ballpoint pens were laying around. Preston watched her silent. She was acting different, something was different.

He was almost sure it had something to do with Meredith. It always something to do with Meredith ... She is her person, he knows that, but sometimes ... they´re like the twisted sisters. They have a Special bond nobody will be ever able to break. That is for sure. He remembered her complaining about an irregular heart beat when she scrubbed in on his surgery ... Maybe that was about that. "Did you know that Meredith Grey complained about premature ventricular contractions, Cristina?" He asked.

"What? She did? When?" He had her full attention within minutes.

He saw that she somewhat looked up atrial switch operation by Senning. Cristina knew nothing of the operation. It had to be something. He couldn´t figure out what. And he had no idea that he would find out in the near future. Cristina still couldn't believe it that her person has been born with a life- threatening heart defect, that could have killed her more than once ...

* * *

Meredith ran through the hospital corridor, she had finally completed the medical records and wanted to go home. The past 48 hours had demanded enough of her. "Grey, where they want to go?", Dr. Bailey wanted to know of the surprise assistant doctor. "I ... uh ..." Meredith stammered helplessly, then she took a deep breath and began to set new again at. "Shall I complete any medical records files, take some blood, insert intravenous lines?" She asked, preparing herself for some crappy work.

Dr. Bailey enjoyed her face for a second, then she grinned. "Go home, Grey. You look terrible." Meredith was kinda surprised, because that was unexpected. "Well, go, Grey. I expect you here tomorrow in time for rounds." Dr. Bailey added in her usual tone. Meredith nodded and left the Seattle Grace Hospital. At the entrance she paused, took a deep breath and then ran to her car. But soon she felt her chest tighten and she stopped, heavily breathing. The world went fuzzy again. Damn it, why did this continue to happen? She didn't know why.

Izzie and George were still working and Derek was stuck in surgery, the surgery was more complicated than expected, as Meredith set out to leave the hospital. Actually she wanted sit in the gallery and watch Derek´s surgery because the procedure he performed was an interesting surgery. But she was definitely too tired to do a step. But that's life as an intern. That is even more strenuous and tiring. She was exhausted from this. How would it be when she had to do 72 hour shifts? Would she collapse? Let's hope for her sake she would never find out.

Meredith sighed and left Seattle Grace Hospital. Cristina was already gone. Meredith could bet that she was still shocked by Meredith's secret. Sure, if she would be in Cristina's situation, she'd be too, definitely. She couldn't imagine how Cristina felt. How it was to get such a bomb dropped on someone. She could not imagine what that felt like.

When Meredith arrived at home, she decided to eat something and then sleep. Meredith opened a bottle of water. She also liked Tequila, but that wasn't that good for her heart and took therefore more strain on her already damaged heart. She took one sip and then closed it. Too much wasn't good. Like said, too much strain on her already damaged heart. But she liked to go to Joe's and drink some shots after work. That was fun. But then she heard a car and then someone opened the front door. Who was this? Maybe it was Derek? It has to be Derek, there isn´t another solution.

"Derek?" She asked in a small voice. "Mer? You here?"

She recognized his voice. "Yes, I am in the kitchen." She replied loudly. Derek came into the kitchen, his hair was like every day. It was perfectly styled even after such a long day at work. How did he do this? "So how was your day?" Derek asked curiously. "Uhh ..." Meredith wasn´t sure what to tell. Her day hadn't been really good. She could not say "My day wasn't really good. I've been diagnosed with an aortic valve stenosis and need open heart surgery for the fourth time in my life-" She couldn't tell him that. "I got in on a possible heart surgery, which is quite cool." She finally answered. Hoping that he wouldn't question her.

_But heart surgery isn´t so cool if you are the patient. _

_I know that. From experience._

_And this patient has almost the same heart condition as me._

She thought to herself. "Should I cook something for us or are too tired for that?" Derek asked, brought her back to the reality. Meredith yawned loudly, she swayed a little and grabbed the cupboard for support. Derek noticed her and steadied her hip with his arm. "Are you okay? You don't look good. Are you feeling okay?" He asked concerned. Meredith nodded. "I am fi ..." She began, but yawned again. "Okay, I see you´re tired, so how about we skip the food and move upstairs for some, you know what?" He smiled mighty arousing.

"Let me think... Yes." Meredith laughed and followed Derek up the stairs. Both fell on the bed laughing. After some 'fun' Meredith mumbled, laying in Derek´s arms: "That was perfect, Derek. I love you." Derek smiled his McDreamy-Smile and replied while placing a soft kiss on her cheek. "I love you too, Mer." He murmured in her soft hair. He loved her odor. After a while, Derek noticed something abnormal on her chest, which looked like a ... scar. A surgical scar. On her chest, on Meredith's chest was a scar. From prevoíous surgeries. Why was there a scar? He was wide awake and his mind raced.

_Why the hell did Mer have surgical scar on her chest? _

_Wait a minute, chest?_

Meredith was half asleep.

Her breathing became more even, but he didn´t care.

"What's this, Meredith?" Meredith jolted awake, sitting upright in bed and looked at him sleepily. "What? Why did you wake me?" Oh, no, that is not good. Maybe he found out about the thing. "What is this?" He asked in shock while pointing towards the scar on her chest. Meredith rubbed her eyes sleepily and tried to register what is happening in this very second. And then it got to her. It was her scar. The clearly visible scar right across her chest ... He looked kind of hurt, because she didn't tell him. Crap. Somehow he noticed the scar on her chest.

_What am I going to do now?_

_This wasn´t the way he was supposed to find out..._

_God, what the heck I am gonna do?_

_I have to tell him the truth, have no choice..._

_He deserves that. _

_He is a good man in the storm..._

_Life is not fair..._

* * *

**A/N:_ Hey, there. Thanks for reading this. I really hope you liked this chapter..._**

**_I think all of you know what echocardiography or TTE means, right? It´s pretty Standard diagnostic procedure in paediatric cardiology and because of that very important. It is a non-invasive procedure and can be done without entering any body cavities. A standard echocardiogram is also known as a **transthoracic echocardiogram.** _****_It is really amazing to see your own heart beating on a screen... _****_So, a lot happened. Izzie almost found out something is wrong with Meredith, she did not, but writing this scene was fun. And Cristina's reaction to Izzie's somewhat unbelievable behavior is a given. _****_And finally. Derek noticed something´s wrong with her. _****_What will happen in the next chapter? Curious? I´ll try and post it as soon as possible._**


	7. Chapter 7

**Chapter 7**

* * *

**In life only one thing is certain, apart from death and taxes: No matter how hard you try, no matter how good your intentions, you are going to make mistakes. You are going to hurt people. You are going to get hurt. And if you ever want to recover, there's really only one thing you can say. Forgive and forget. That's what they say. It's good advice, but it's not very practical. When someone hurts us, we want to hurt them back. When someone wrongs us, we want to be right. Without forgiveness old scores are never settled. Old wounds never heal, and the most we can hope for is that one day we'll be lucky enough to forget. **Meredith Grey, Heart of Matter

* * *

Derek was standing there, shock covering his face. Complete and utter shock. He was at loss for words. Meredith didn't know what she should answer. She is like frozen. She could not move and could not speak. She couldn't do anything except breathe. Because she had to. Derek was impatiently waiting for a very much needed answer. Meredith felt ashamed for not telling him. It was the biggest mistake she ever did in her whole life. Derek was looking at her, waiting impatiently for her to answer his questions. "Meredith, why didn´t you tell me?" He asked with a breaking voice. She was avoiding his gaze. Meredith swallowed hard. Then she looked him right into the eye. Derek made eye contact with her. Her blue eyes were looking right into his. For a moment, he enjoyed this moment before he remembered what was going on here.

"I always meant to tell you, Derek. I … I just needed time. You weren´t supposed to find out like that. Please, I was always going to tell you. And maybe I am a bad guy for thinking that you´ll leave me if you knew about…" She stopped in the middle of her sentence. Derek studied Meredith. She was pale, paler than ever before. She looked tired out, exhausted. Why didn't he notice before? She was sick and he didn't noticed. Guilt overcame him and he needed to sit down because his legs weren't able to hold him steady. He wobbled a bit. Then he sat down on the bed, Meredith was still lying there. Her hands were covering her face, she seemed sad and angry. She was angry of herself. She should have trusted Derek. She should have trusted him. Oh, these damn trust issues.

Meredith didn´t finish her sentence. Silence. They could hear each other breathing. Nobody was talking. "If I knew about what, Meredith?" Derek asked loudly, there was slight anger and disappointment in his voice. But also worry. He was worried about her. He cares about her after all. "For all I know is that you have a scar on your chest." He eyed the scar on her chest, then he realized what this means. And the revelation hit him like a ton of bricks. It was horrible- he had never felt like that. It was like he was falling and there was nothing. Free Falling. And then, hard ground when he landed. That was descibing it, but it wasn't all. There were much more emotions. Worry. Fear. Anger. Guilt. Meredith was his only thought. Why was this happening? He realized, his neurosurgeon brain eventually realized what that meant. The scar.

_For Meredith._

_She´d been on the operating table more than once. _

_Most likely because of a congenital heart defect._

After realizing this fact, he swallowed hard and his face expression changed to shocked, because he was shocked, it came all out of sudden. "You've had open heart surgery." He stated with a shaking voice, trying to process everything but it was too much all at once. He still could not believe a single thing. All things were crashing down on him out of sudden and there was nothing he could do. "Yes, I've had open heart surgery three times when I was a child." Meredith confessed. Derek just stared at her, couldn´t believe what he was hearing and couldn´t help but feel sorry for what she´d been through when she was a child. He could truly believe it was not easy to live with something like that. There was no way that it could have been easy for her or on her. Surgery is ...

Meredith waited a few second before continuing: "I was born with a heart defect. A congenital heart defect. Actually, there were three different kinds of cardiac abnormalities." She paused, trying to gain control over her emotions but everything was just weird and stressful and exhausting for her. She knew she needed rest. Derek just listened to her telling her story, because he wanted her to have the chance to explain things. She needs to have that chance. It wouldn't be fair otherwise.

She deserved to get a chance to try and make things right between them.

She deserved that chance ...

And Derek wanted nothing more than to hear her out.

"At first the doctors thought everything was normal and I was born healthy. That´s what they thought, but the truth is that I wasn´t healthy. The only indication were my somewhat low oxygen levels, but they blamed is on the fact that I was born a few weeks premature. I was a preemie, so they didn´t order any further tests, until I developed severe cyanosis ... My condition deteriorated fast, I have gone into cardiogenic shock, I suffered from metabolic acidosis with BE -5. My patent ductus arteriosus closed and my heart started to fail." Meredith's voice shook as she told him that. Derek shuddered, his heart began to beat faster. Meredith stared at the wall, trying to sort the thoughts that were overwhelming her.

What will he do? Will he run? She hoped he wouldn't. But she wouldn't blame him if he did. "I ... sorry ... I ..." Meredith didn't know what to say. "Mer." He said, gently running his thumb over her cheek and she looked at him with big eyes. Unsure what to do. She feared one false movement would destroy everything.

"Yes." She responded, unsure of herself.

"Meredith, look at me." Slowly, she looked up. Right into his eyes. "It's okay. Just go on." He calmed her.

Meredith's heart raced. She was having all sorts of self- destructive thoughts. Her mother had told her everything she needed to know about her heart condition as soon as she was old enough to fully understand what it means. That is how she knows. After she found this chart with all these echocardiography pictures and chest x-rays and other things related to that, she found out more than she already knew ... She never knew about the fact that she had bacterial tracheitis as a kid. She was too young to remember ... "Surgery was the only option to save my life." She told him with a quiet voice.

Derek shuddered slightly when he heard those words.

Meredith stopped and took a deep breath, before she revealed the whole truth about her shocking medical condition. Instead of saying something Derek simply took Meredith´ hand and squeezed it slightly to comfort her. Meredith gave him a weak but thankful smile. Meredith told him with a small voice: "The cause was an interrupted aortic arch, short IAA, but I think you know that considering you´re a surgeon." "Neurosurgeon. I am a neurosurgeon. Burke is the cardiothoracic surgeon at Seattle Grace. You should know that." Derek immediately commented. Meredith shot him a glare before continuing with her story.

"This is so not funny, Derek. Let's get back to the point. IAA requires immediate surgery. I am sure you know that even though you´re a neurosurgeon." Meredith paused.

"That's right, I am a neuro god." He grinned.

She slapped him playfully on the arm. "Hey, now is not the time."

"But I am." Derek said, not sounding a bit ruefully. "And you are the best intern I've ever seen my entire career."

Meredith chuckled, but suddenly got serious. Derek noticed it too. "What's up?" He asked. "Isn't it a bit weird that we are talking about that right now?" She wanted to know. "Maybe. I don't know." Derek answered honestly.

"They also discovered that I've had a congenital defect called Double Outlet Right Ventricle. Because of the interrupted aortic arch they rushed me into surgery as soon as possible. In surgery they also discovered that my Taussig- Bing- Anomaly was combined with an Atrioventricular Septal Defect. The interrupted aortic arch was corrected with a Yasui- procedure in the first surgery, then after three or five months, they did the second procedure ... " Meredith replied, trailing off ...

Suddenly, Derek thought about something, he cursed himself that he hadn't thought about that earlier. Then he asked the important question which would determine if there were residual defects and what kind of procedure it had been. He hoped it had been a corrective procedure. The chances were lower for complications than with palliative procedures. Also, she was at risk on getting bacterial endocarditis whenever she went to the dentist's for dental caries prophylaxis which meant she had to take a broad-spectrum antibiotic to prevent bacteria to get to her heart ...

"Second corrective procedure? Right? It was corrective?" Derek wanted to know. He was scared about what she would answer. What if it hadn't been corrective? They were looking at a lifetime of possible cardiac complications.

Meredith just looked at him and immediately he knew that it hadn't been a corrective procedure.

"The surgeons at Seattle Pres decided to perform an atrial switch surgery-" Meredith explained quietly, her voice quivered when she searched for the right words. "God, that means your right ventricle pumps the blood into your system. Am I right?" He interrupted out sudden, panic was evident in his voice. He sounded shocked, which was totally understandably considering the situation. Meredith gazed at him and nodded slightly.

"You are right, it wasn't a corrective procedure neither anatomically nor physiologically." She then confirms his suspision. "My right ventricle pumps the blood into my system and the left ventricle circulates the blood back to lungs. Then, when I was five years old, I had a cyanotic seizure. They discovered that my right outflow tract had been too small. It was a RVOTO, right ventricular outflow tract obstruction. Over the years of my childhood I was in and out in hospitals. Can you imagine that, living with a heart defect?" Meredith said, finished with telling her story.

Silence. Meredith could herself and Derek breathe. Nobody said a word, they just sat there in silence.

Derek just sat there for a long, long time and doing nothing. She heard him breathe in and out, slowly. In and out. He tried to process everything he had heard and tried to wrap his his mind around all the information he got. Meredith was getting nervous when Derek didn't say anything. Tears were in her eyes. Maybe she had just destroyed her relationship with the love of her life. What did she think about that? Why did not she tell him about everything? Had she really been that dumb? Obviously, yes. She decided to take things into her own hands and was about to ask him what he thinks what he will do. "Derek, can totally understand if you need time to process everything …" Meredith said, while choking tears back. Derek answered: "Meredith, I…" But before he could finish his sentence, both of their pager signaled an emergency.

"Looks like we have to work." Meredith commented.

"And I was hoping to get some sleep." She added, sighing loudly. Derek watched her with a worried expression. Meredith knew what he was thinking.

"I am okay, Derek. You don't have to worry about me." She backed away. Maybe you will leave me anyway, she thought, guilt washing over her. "I worry about you even if you don't like the whole Hovering- thing, because I love you, Mer and it's the right thing to do if you love someone. And you not telling me from the beginning? Well, it came as a giant shock, but it doesn´t change anything. I still love you, even if you made mistakes. I made mistakes too, it's what makes us human. I make them, you make them and then we learn from our mistakes. Mistakes are human. But we can discuss the whole situation after we come home tomorrow. Now we have to get going." He told her. Meredith silently cried when she heard his words.

He was not going to leave her. He was not going to leave her ...

"Hey, Mer." He said, embracing her in a tight hug. "Come here, it's okay. I've got you." He said, he softly ran his hand through her hair and enjoyed their hug. "Someone special like you I will never find again. I love you, Mer and I want you." He assured her, mumbling these words in her brown blonde hair.

Meredith just sat there. She did hear her pager, but she just looked at Derek. He knew and he wasn't going to leave her. "So you are not going to leave me?" Mer asked with a small, shaking voice. Fear sounded in her voice. She was pale and looked extremely fragile. "No." Derek exclaimed, seemingly surprised. Why would she think that, he asked himself. He was would never leave her. "Why'd you think that?" He asked carefully choosing the right words. "I lied. I freaking lied about everything. You should hate me. I am a liar. Nobody knows. Just you and Cristina know." She confessed, avoiding eye contact with Derek.

Derek looked at her for a few seconds. He couldn't believe his ears, was she really saying that he should hate her for what she had done? That she doesn't deserved him? A good man like him? Why on earth would she think that?

"Wait, you said something about me hating you?" He asked shocked that she would even think that.

"I am a liar. I don't deserve you."

He sat next to her, embracing her in a giant hug. Meredith relaxed in his arms and he mumbled in her hair: "I could never hate you, even when I hate you, Mere." He confessed his deep feelings to her that wouldn't just go away because she didn't told him a little detail. "Really? You won't leave me? I mean, you didn't tell me about your wife, Derek. Please don´t, I would have told you some day. Really, please believe me when I say that." Meredith rambled nervously. She sometimes had a hard time stopping when nobody stopped her. Derek listened to her, then he did something to stop her from continuing to ramble. First he tried with words, then he had an idea. "Meredith, stop." Derek quieted her with a small kiss placed on her lips. "Sorry." He said. "It was the only way to interrupt your rambling, Mer. Actually, it is pretty sweet." When Derek told her that, she blushed a little.

Just a little. But it was sweet.

"You are a great and strong person, Meredith, but you are so stubborn. I love that about you. You're sweet, loving and caring and you deserve good things happen to you. So, Mere, when you say you don't deserve me, you are wrong, you deserve love and happiness and I won't go anywhere, except with you - I love you, Meredith. I won't leave you because you withheld that little detail." Derek said. "Look who is now rambling." Meredith chuckled, she was already back to her old self.

For a moment nobody said anything. They just sat on their bed in a hugging position.

"Wait." Derek interrupted the silence. "You said nobody except me and Cristina know about you suffering from a CHD?" Meredith nodded, looking to the ground. She already knew Derek would be for telling Bailey and Bailey about the circumstances. Derek's brows were furrowed as he looked at Meredith who was still in his arms. "Just me and Cristina? You told her? What about the chief and Dr. Bailey? Do they know about your heart condition?" He wanted to know. But before Meredith had the chance to answer the pager beeped again, loud enough for them to hear.

"The accident. God, I totally forgot about the ER page." Derek muttered almost inaudibly but Meredith had heard him. She grimaced and had the same opinion as him. As much as she loves her job, sometimes it's really determining your whole life. And some people really need to learn how to freaking drive in the winter. It was still ice cold, it was snowing. But hopefully the snow would be melting soon. He and Meredith put some clothes on, before rushing to the hospital. With Derek driving the car, Meredith watched the streets go by and the sun disappear behind the sea. Then they reached the hospital. "We are here." Meredith said and opened the door of her car as soon as Derek had stopped it in the place where it belongs. "We are." Derek said, grasping Meredith's hand and they both entered Seattle Grace Hospital.

* * *

Then they saw the sign: Emergency Department, Seattle Grace Hospital and knew that they reached their destination. It was going to be a long long day. Exhausting. Meredith and Derek chared a look and then they stared at they chaos that was the pit. There were so many injured patients, all beds were occupied. There were already gurneys standing in the hallways and blocking them. "Wow." Meredith said, looking at the scene. "That is gonna be long and exhausting." "You might be right." Derek answered with a nod. "Now come with me, we have lots of work." He advised her. When they came to the pit, Meredith just said after one look: "Now that is gonna be one long night, Dr. Shepherd." Meredith said, dark rings were under her eyes.

"You're right, but why did you call me Dr. Shepherd?" He asked interested in why she had done that. "Because we are professionals at work. We agreed our relationship wouldn't interfere with our work." Meredith replied simply. "Aha." Derek responded. The ER was full of injured patients. All available beds were occupied. Someone was shouting for a crash cart in curtain six. Then Dr. Webber was coming towards them. He was all hectic, in working- mode. He approached to them. "We have a head trauma coming in. Ambulance is two minutes out." He called over to Derek and Meredith. "What happened?" Derek asked, wanted to know what the situation was.

"Bus collided with car. Means lots and lots of patients and we've got more incoming." Dr. Webber explained. "No no no, don't. The path has to stay free." He said to a nurse who wanted to park a patient there. "Where do need me?" Meredith asked, unimpressed from the chaos around her. "You're with me, Grey. Come." Derek interjected, before Dr. Webber could answer. Meredith obeyed without any further questions and followed the neurosurgeon. Meredith and Derek waited outside for the ambulance. They could hear the sirens wailing and thereafter the ambulance arrived with sirens.

The blonde-haired paramedic jumped out and opened the back of the ambulance. "34 year old male, crashed his car into a pole. Sustained possible closed head injury. Increased intracranial pressure, GCS is 6. He was hypotensive en route. He was conscious for a few minutes on the scene but passed out again in the ambulance." The paramedic stated the facts. „Clear a trauma bay right now." Derek ordered. Meredith and he worked on stabilizing the patient.

"Make sure CT is on standby. If there is a bleed or something and I need to go in, I want the OR prepped and ready the minute I know what we´re dealing with." He ordered loudly. "Of course, doctor." The nurse quickly replied and contacted the OR. But all ORs were being used. They were swamped with so many patients and a grear amount of them needs surgery. They were swamped, backed up. Meredith and Derek were in the trauma room, trying to stabilize the patient, but they couldn't get his blood pressure up.

„We need to consult general. His abdomen is rigid. Page Dr. Bailey. And then get him to CT." Derek constructed, while testing the patients pupil reaction. They were reacting a little sluggish. Before the doctors could do anything the patient started crashing. "Damn, he is crashing." The heartbeat became more and more irregular and monitor signaled with a rapid and erratically tone that the patient had gone into ventricular fibrillation.

"Damn it." Derek muttered, before shouting: "I need a crash cart now."

Meredith immediately responded. She handed the paddles. „Charge to 200. Clear." He warned the others. He shocked the patient once, but he didn't respond, neither to the first round of ACLS drugs or to the shock. "Charge again." He wasn't about to give up and let this man die. He pressed the paddles to the patients chest. "Clear." The next shock sent the patient´s body flying upwards and back on the gurney. After three rounds they were able to revive him. "We really need to get a CT done." Dr. Bailey waited for them in CT. The short- legged woman was waiting impatiently on the results.

"What do we have?" She asked. "MVC, he suffered traumatic brain injury and possible abdominal injuries, that´s why we paged you. We are still waiting for the images to come up." Derek answered. After a while the images were up. "Damn, he has suffered major trauma to his abdomen. Grade IV liver laceration." Bailey stated after looking at the images. "Well, that's not all. What can you see, Dr. Grey?" Derek directed to Meredith, who studied the monitor carefully, before answering: "Acute Subdural Hematoma. He needs an emergency craniotomy. Causes are major trauma and it has a mortality rate of 50%." "You are right, the hematoma expanded along the inside of the skull, and it's creating a concave shape that follows the curve of the brain, stopping only at the dural reflections like the tentorium cerebelli and falx cerebri. We need to get him to the OR."

"Well, then let's get him to an OR, before he bleeds out."

The surgeons rushed the patient to the OR, but there weren't any available ORs. "How come there is no OR available. I have an emergency craniotomy or my patient will die." Derek was furious. The nurse stuttered helplessly: "I cannot do anything about it." She looked overwhelmed by everything but Derek did not take a no for an answer. "Well, bump any non-emergent patients. Clear the OR rotation now and maybe someone just started operating. Maybe they can close up. I don't care, just get me a damn OR." Derek was adamant.

The nurse nodded and reached for the phone.

"That seemed to work. What is surgical plan?" Dr. Bailey commented. "I will go in first to relieve the intracranial pressure and when I am finished you can start fixing the liver lac? How does that sound?" He wanted to know, looking at the heart monitor which was beeping in a normal rhythm. "Good. Will you page me when you´re done operating?" "I will." Derek replied. The nurse interrupted with: "OR 2 is ready." They rushed the patient into surgery. Meredith assisted Derek in surgery. Brain surgery was interesting. The brain was a mysterious organ. That is why the brain is so interesting. It was quiet in the OR.

Any loud or disturbing noises weren't welcome, because it was important to concentrate. "Can you see that?" Derek asked and Meredith nodded. "That is the bleeder, right?" She asked interested in the surgery she was whitnessing. "Yes, you are definitely right." Derek responded and smiled under the mask at Dr. Grey who replied with smile in his direction. "I am starting to remove it. Suction, now." Derek voiced.

Then there was noise from one of the pagers.

"Whose is it?" Asked Derek slightly annoyed. "It's your pager, Dr. Grey." The nurse replied and read the message: "It's a page from Dr. Burke. It says you should come to patient room 12534." Meredith breathed in, then out. "That's Lily, the one who is here for a heart procedure." Meredith mumbled to herself, but Derek heard her. "Who is Lily?" He asked. "I will talk to you later, Derek." Meredith stepped away from the operating table. This page could mean something had happened to Lily. Meredith scrubbed out and ran to Lily's room.

Dr. Burke was already there. "What happened?" Meredith asked, a little bit gasping for air. "She's been having arrhythmias. We are going to do an EP study, which is short for electrophysiological study." He was half talking to Lily's mother and half to Meredith. Meredith always hated this when she was the patient. Every three years they did a heart catheter on her, while she was laying there wide awake, although they´d always given her a sedative. That reminds her that she needs to schedule one in the near future, but that would mean that she has to tell the Chief and Dr. Bailey.

Everybody would know if she decides to do it here in Seattle Grace Hospital. "Are we doing it now?" Lily asked sleepily, having a hard time to keep her eyes open. "And more important: Does it hurt? Will I have to be awake, Dr. Grey?" Meredith wasn't surprised that she directed her question to her. She was born with a heart defect too, so chances are, she already had one and knew how it worked. Dr. Burke face expression showed surprise. Well, he didn't know why. And it should stay that way. Meredith felt everyone's eyes on her and she was nervous.

Meredith felt panic rise up in her, but she tried to stay calm and answer her patient´s questions.

"We will do the electrophysiological study now. We will start prepping you after I explained everything. You'll be awake during the procedure, but we inject a sedative, so you won´t feel any stress and discomfort, so you´ll be more relaxed. During an EP study we use really small, thin wire electrodes that are inserted through a vein in the groin. The wire electrodes are threaded into the heart, using a special type of X-ray. Electrical signals are sent through the catheter to stimulate the heart tissue to try to initiate the abnormal heart rhythm disturbances for evaluation. It is an invasive procedure that Dr. Burke will be performing in a cath lab. Hopefully we´ll be able to find out what causes your syncopes."

Lily slowly nodded. She knew exactly she didn´t have a choice, so she didn´t even tried to protest. Maybe they will find out what is causing the syncopes. After all the questions were answered, a nurse came to prepare Lily for the procedure.

After Burke left the room, Meredith said: "I'll see in cath lab, Lily." "You'll be there too, right?" Lily asked, she wanted to know for sure that her favourite doctor was going to be there too, she was slowly sitting up. "Of course, I'll be there the whole procedure." Meredith replied with a confident voice. "That´s great, because I trust you. You´ve been through all of this and against all Odds you became doctor. I mean this gives somebody in a Situation like this a whole new perspective." Lily explained. Meredith smiled. She hadn't thought about that in this way.

* * *

After Derek finished his surgery he went to find Mark. He wanted to go to Joe's Bar. He knew they weren't exactly close anymore (they were, but neither of them wanted to admit that they needed each other. They were too proud), but he really needed someone to talk to. He couldn't talk to Burke, even if he hadn't been in the cath lab performing an electrophysiological study. Meredith was the intern assisting on that case. He found Mark near the OR board, where he looked at the OR board, stunned. "Which idiot canceled all my procedures?" He wanted to know. "Haven't you heard?" Derek asked. "We've had incoming trauma patients because of some accident. They canceled all elective surgeries to clear the ORs for emergencies. Anyway, that is not why I am here." He ended the sentence"Oh, is Meredith giving you a hard time?" Mark laughed.

"Stop that. Mark. Don't talk about her in that way."Derek hissed. Mark frowned when he watched Derek's harsh reaction. "No need for you to get so defensive." Mark replied. "Why can´t you be serious for one damn Minute. Hell, you slept with my ex-wife - okay, I am not going there, sorry. Have you time to go to Joe's Bar. There are none of these gossipy nurses." "What is your problem with the nurses. They are really good in ..." Mark began, but Derek cut him off. "Oh, Mark. I don´t wanna know. Just don't complete thís sentence. There are certain things I don't want know. I am in a steady relationship and I will be. Now, what about a beer at Joe's." Mark looked at his friend with a frown.

"Okay, okay. Man, is everything okay. I mean you look like you are bit in over head." Mark continued. Both of them headed to Joe´s bar for a drink. "So why'd you want a place without the gossipy nurses?" That was Mark's first question as soon as he took his first sip. "Because they love gossiping. And some things are better off if they remain a secret." Derek answered secret- like, avoiding Mark's gaze.

"Now you lost me." Mark took a sip of his drink.

"You won't believe me, Mark, when I tell you this." Derek shook his head. "C'mon. Just tell me. I am your best friend." Mark reacted, looked at him expectantedly. "Well, I am sure you won't because it is freaking unbelievable. I mean I have mever known a person who was ..." He didn't finish the sentence. "Shep. I don´t understand what you are talking about. What person was what? Clarify yourself." Mark said worriedly as he looked at the surgeon.

"Meredith has a heart defect."

Mark choked, while spitting his drink on the desk and started coughing and gasping for air. Derek watched his friend trying to breathe. Derek felt helpless as if telling Mark made everything very very real. Meredith is ... was ... is ... sick. He didn't know what to do. It was a big thing. When he could breathe again, he said: "This is a joke, right? You are joking or am I on drugs and this some kind weird experience." He shook his head, obviously he did not believe him. "Or is this some kind of weird payback for the wifey- thing?" He asked. Derek looked at him angrily, his stomach churned when he heard Mark asking that.

"No." Derek shook his head, he clenched his fists, trying to gain control over his wild running emotions.

"It´s the truth, but the whole truth is nobody knows, let alone Bailey and the chief. And she didn´t even tell me. I figured out when I saw the surgical scar on her chest. Only then she told me about her medical condition." Derek supported his head with his Hands as he stared at the dirty table top. Mark didn´t know how to react or what to say in a Situation like this. "But Mark, no gossiping, okay? Don´t tell anybody about what you heard. This stays between us. Otherwise I will get very displeasing and angry. So, please for god´s sake, keep your mouth shut. I mean it, really."

"I promise I won´t tell another living soul in this hospital." Derek glared at his ´used to be-best friend´, until he sighed and corrected: "Fine, won´t tell anybody. Happy now?" "Good. I hope for that you will Keep your mouth shut, because it could cause Problems for not only me, but for Meredith, so I told you this as a friend. So don´t disappoint me, Mark." Derek repeated another few times.

Mark looked him in the eye, then he sighed.

"Shep, I may have slept with Addison, but I am not an idiot." Mark reassured his friend. "Joe, can you get him another Scotch? I´ll pay." Joe nodded. Derek looked up, no longer avoiding Marks gaze and said: "Thanks, Mark, for being here." "Well, that´s what real friends do. Help eachother out if there´s some sort of crisis. And I think this is a kind of crisis, right?" Mark asked. "It definitely seems to be." He answered the question himself shortly afterwards. Derek did not reply, but that was not neccessary.

"Finally you get it, Mark." Derek mumbled in his half filled glass with Scotch in it.

"I need details." Mark suddenly said. "You can´t you drop a bomb like that on me and then expect I have no questions." "Well, I do." Derek answered. He emptied his Scotch with one gulp. "Pleeaase, detaaaaaaaaaaaails. Come on." Mark pressured him. "No, I don´t tell you the details. It is just more ammo for you and if you accidently slip, Meredith will kill me. Literally."

"You´re funny, Derek. She would never do anything like that to you."

"I wouldn´t be so sure."

* * *

_**A/N: Hope you liked that chapter.  
**_

_**Cardiovascular surgical procedures or operations may have one of several goals. **__**Anatomically corrective **__**procedures are required to make heart structures normal. **__**Physiologically corrective **__**procedures are required to separate and/or Redirect **__**the blue and pink blood circulations. These corrective procedures range from **__**the relatively simple, such as closing or patching a hole or tying off a vessel, to the **__**complex, such as switching vessels or rerouting blood streams. **_**_Palliative procedures are required to improve, but not correct, an abnormal heart function. Palliative operations are performed to improve the heart function, usually in children too young for corrective surgery or sometimes corrective surgery can't be done like in cases when one ventricle is hypopastic or the structures of the heart aren't like they should be in order to the corrective procedure. The aim is to lessen cyanosis, to control heart failure, or to prepare the circulation for later repair._**

_**A Subdural hematoma, also known as a subdural haemorrhage (SDH), is a type of hematoma, usually associated with traumatic brain injury. Blood gathers between the dura mater, and the brain. Usually resulting from tears in bridging veins which cross the subdural space, subdural hemorrhages may cause an increase in intracranial pressure (ICP), which can cause compression of and damage to delicate brain tissue. Subdural hematomas are often life-threatening when acute. Chronic subdural hematomas, however, have better prognosis if properly managed. Large or symptomatic hematomas require a craniotomy, the surgical opening of the skull. A surgeon then opens the dura, removes the blood clot with suction or irrigation, and identifies and controls sites of bleeding. **_

_**Acute bleeds often develop after high speed acceleration or deceleration injuries and are increasingly severe with larger hematomas. They are most severe if associated with cerebral contusions. Though much faster than chronic subdural bleeds, acute subdural bleeding is usually venous and therefore slower than the typically arterial bleeding of an epidural hemorrhage. Acute subdural bleeds have a high mortality rate, higher even than epidural hematomas and diffuse brain injuries, because the force (acceleration/deceleration) required to cause them causes other severe injuries as well. The mortality rate associated with acute subdural hematoma is around 60 to 80%.**_

**_I will try to post the next chapter as soon as I can manage. Please leave a review ..._**


	8. Chapter 8

**Chapter 8**

* * *

**Every surgeon I know has a shadow. A dark cloud of fear and that follows even the best of us into the OR. We pretend the shadow isn't there hoping that if we save more lives, master harder techniques, run faster and farther it will get tired and give up the chase but like they say... you can't outrun your shadow. Every surgeon has a shadow. And the only way to get rid of a shadow is to turn off the lights, to stop running from the darkness and face what you fear, head on. **Meredith Grey; I will Follow you Into the Dark

* * *

When Meredith came home late from work, she did not expect Derek waiting for her in the kitchen. Last, she had seen him in surgery when he removed a tumor from some man's brain. She had watched part of it before she was called away to do stupid intern work. "Mer, You're here. I've been waiting for you. I missed you." Derek called soon after Meredith's keys could be heard when she opened the door and entered the house. "Derek. You're here. Sorry, Bailey had me doing all the crap work." "But you're home now." Derek said, kissing her. "I am." Meredith went to get herself a glas of water. "Do you want one too?" Derek shook his head in reply. "I only need you. I missed you." "You did see me at work, you know. But I missed you too." She commented and grinned at him. Derek laughed. "Yes, indeed that is right."He came nearer and suddenly sniffled on her hair. It smelled like Meredith, he loved that scent. Lavender. "Anyway, you're here now, so … Why don't we talk about …" Derek trailed off. Meredith immediately tensed. There was no way back now.

They had to talk. They also had a lot to talk about. "It's okay, Mer. I am not going to bite your head off if that's what you are fearing." Derek said softly as he noticed Meredith tense. He grasped Meredith's hand and her fingers twisted into his. "I told Mark." Derek confessed. He knew it wasn't right to tell Mark without even talking to Meredith. It has been a spur of the moment - action. Meredith just stared at him. Meredith Grey can't believe it. She trusted him. And now? He broke it, she told him not to tell anyone but he did tell Mark. How does that ... There he goes and tells Mark Sloan of all people. She couldn't believe him.

"Meredith." Derek began, but Meredith cut him off, before he could even really start the sentence with a sharp and disbelieving voice: "I just cannot believe what you did. You told Mark, before even asking me if it is okay for me. It is my damn heart and my damn heart defect. So I get to decide whether I tell somebody about my medical condition or not - even if he's your best friend or used-to-be friend, whatever."

Her breath hitched.

Meredith chest heaved up and down with each breath she took.

"I needed someone to talk to, Mer. It was a shock when you told me about your heart defects. I needed to sort things out and wrap my mind around it. And you talked to Cristina as your Person and Mark is sort of my person. I even made him swear that he won´t tell anyone." Derek defended his course of actions. "You know exactly how this works, Derek. If he accidently lets it slip, then within a day everybody will know about it. And with them Dr. Bailey and Chief Webber."

"What, they don't know?" Derek asked back solemnly.

"Of course not. My mother never talked about the fact that her daughter had been born with a heart defect, so no, he does not know." Meredith hissed. She drew in a deep breath. Derek watched her. "It's not the kind of thing you want to tell your superior when he's looking for a freaking reason to fire you. My mom's a too good surgeon to let that happen to her. I don't know if I would tell my superiors that my child has been born with a CHD, which happens by the way, about 40.000 times in US, each year. Hell, I mean that's a lot, isn't it?"

"It is." He confirmed.

Derek looked at her perplexed, his mouth hang wide open.

"If I get fired because Sloan told the Chief or even worse, Bailey; it's on you, Derek, because you weren't able to keep things to yourself." She gave vent to her anger.

Meredith knew she was overreacting, but she couldn't help it. The feeling that he deceived her with telling Mark Sloan. "They are gonna fire me once they know." Meredith said quietly. "I can't, I can't afford to lose that job. I want to live up to my dreams I've head since childhood - I want to find a cure for some ugly disease, maybe inventing a new surgical technique. I want to change the face of medicine. Yes, my dreams, they just don't involve that, but it's one the things I want to accomplish. Yes, I know my expectations are pretty high - I probably shouldn't do that ... What if I can't keep up with her? She was a freaking legend, I am just starting to be great. You already are great, a great surgeon, I am still an intern. When I lose this job, I'll never have the chance to try to become a surgeon as I always wanted." Meredith finished, her eyes were fixated on Derek.

"Nobody is gonna fire you. You could have been honest from the beginning. If I were you, I would have told Bailey and the chief. I mean they are in charge of you." Derek reasoned. "So that is where we going? Don't make this about me. It's about you telling Mark without my permission. You and your big mouth. And just for the record, I know who is in charge of me, Derek. I may be sick, but I am not an idiot." Meredith shot back. Derek rolled his eyes and replied patiently: "I never said you were an idiot, Meredith. I simply said that you should tell them, in case something happens. I mean what if you aren't able to talk, Cristina and I aren't there and nobody has a plan? What happens then? This, Mer, isn't something I do to torture you, this is something I do because I care about you." He looked her directly into the eyes.

She lowered her gaze. Meredith didn't say anything, maybe she was thinking about what he'd just said, since it was true. She really could get into trouble for not saying anything, not even speaking of the fact how she is endangering her health and the health of her patients if something unexpected happens and nobody really has a clue what is going on. "What if you pass out or having some sort of life-threatening arrhythmia, what will you do? Oh, I forgot, in a situation like this you are not able to do anything. They can react much faster if they knew about your heart condition." Derek didn't gave up. He wanted Meredith to understand the possible consequences of her actions. The _potiential risks_ that are coming with it.

Also, she was acting irresponsible with not being forthright with her health. Bailey would ...

"Yeah, Derek, big-shot neurosurgeon who knows everything, has spoken."

Meredith made fun of the seriousness of his voice, her tone dripping full of sarcasm. "Stop with sarcasm, this is a serious topic." Derek replied sharply. Meredith scoffed. What did he know? He hasn't been born with a heart defect like she was."Don't you think I am aware of that, especially since I am the one with the sick heart and not you? I am painfully aware of that fact. Painfully aware." Meredith glared at her boyfriend. Derek eyed her. "I know that since my first echo that I know of. I know that a heart defect is serious in most cases, some cases aren't, but most are. Mine was. So I am painfully aware of that fact, thanks to you." Derek gave a short fake laugh, but immediately got serious when he noticed changes in Meredith's behavior and her breathing quickened within seconds.

Worriedly he asked: "Mer, maybe you should sit down." She swayed, she was trying to get a hold someplace. But her whole world kept on spinning. She could hear Derek telling her to sit down but she was way too stubborn to give in. Meredith ignored his desperate pleas. She was fine, or at least she pretended to be absolutely fine, But she wasn't. The room was spinning around her, her legs felt wobbly. Darkness clouded her eyes and she gasped for air as lungs wouldn't allow her to suck in oxygen. She was oxygen deprived. "I am fine." She answered wearily and unfocused, of course he did not believe her. She looks like she going to faint any minute.

Derek noticed in horror that her face and her lips were turning blue. Her face is as pale as the white wall behind her. She tried to breathe equally as she tries to straighten herself and get a hold of herself, before she is passing out. She has a feeling like she is. Derek noticed her struggle to steady herself. He came closer, wanting nothing more than to help her.

"Meredith, talk to me, please. Tell me what's wrong ... Sweetie, please, tell me so that I can help you." Derek said panicking slightly, he has never been in that situation, not in such a situation where a loved one was fainting or about to faint. "Mer, concentrate on me, you need to tell me what is going on." Derek tried another time.

She looked at him, panic and fear in her gorgeous eyes.

"Can't brea… breathe… pass… out…" She managed to get out before she finds herself falling.

Derek reacted instantly and caught her before Meredith before she hits the ground.

Derek held the fragile, unconscious form of Meredith in his arms and he couldn't recall any medical stuff right now. Derek's mind was blank, like a paper with nothing written down on it or a computer crash. All of his medical knowledge disappeared. It was like a blackout. Total and complete blackout. He was frozen. So that is the reason why family members don't treat family. Now that rule makes sense. They can't act nor think clearly or rational. They are too involved - emotionally speaking. _What am I gonna do? What am I freakin' going to do?_ He panicked, but then Derek tried to get himself together in order to help Meredith, because he freaking out isn't going to help Meredith. He laid Meredith's limp outstretched body down on the ground carefully and then placed her in the recovery position to protect her airway, so she can breathe.

_If she is…_

He put his finger on her neck, trying to find the pulsating _A. carotis interna_. His fingers were searching for a pulse. Tracing his fingers on her soft skin, counting he beats per minute. He hoped her cardiac output was okay. Almost automatically he did it although he had no idea how he did it. Everything was a messy blur.

Derek checked pulse and breathing. Her pulse was a bit low. He barely could feel the _A. carotis interna_ pulsating under his fingers. "C'mon Meredith, you can do it." He pleaded. Then her pulse got stronger with each heartbeat. But he was shocked. Both were normal or at least almost normal, which about he was more than relieved. Her breaths were frequent, only her pulse was lower than normal and not as strong. "Meredith." He spoke loud and clear, desperately hoping she would respond, but so far nothing. Meredith didn't respond. He shook slightly at her shoulder. Maybe there will be a reaction. "Meredith." Derek's voice was now breaking.

He was feeling so damn helpless right now ...

He was already grabbing his cell before he made a call. His fingers were

"Please wake up. Don't make me call… Mer?" He asked, almost thinking that his mind is playing tricks… Meredith slowly woke up, she opened her eyes. She let out a slight moan. Her head was pounding, she felt dizzy and finally she knew what had happened to her. She collapsed, passed out while arguing with Derek. Apparently it had been too much for heart to take in.

"Meredith? Can you hear me?" Derek asked, his voice was full concern for her.

It was a very worried Derek talking to her. She heard him, but she didn´t have the strenght to answer him right away. After a while she felt a bit better. "Derek? Of course I can. Why did I pass out?" Meredith finally responded, still having a little trouble breathing. "I am pretty sure it has to do with your heart. But to be sure we should get you to the hospital to get some tests done." Derek answered, not showing how he is really feeling.

"Oh no, I don´t wanna go to the Hospital." Meredith protested weakly, she tries to push herself into a sitting position. Derek watched her attentive. He was alert in case she is gonna faint again, because that would happen if she stands up to fast after something like that. She shouldn´t be doing that. He should have called the damn ambulance. "Meredith, you have a serious heart condition and you passed out in my arms. So yes, I say, we go to the hospital." Derek prioritized. "But then everybody will know..." Meredith replied.

* * *

**Meredith, 16 years old**

_Meredith was sixteen when she suffered an atrioventricular block. At that time they had gotten the whole thing with antiarrhythmic drugs under control. She was lucky that it was not a AV block III ° have been, because there would be an indication for a pacemaker. And a pacer with sixteen years? That would have been to hard. Too unfair, way too unfair. But life's never fair. No, it was an AV block was II ° type Mobitz II. It was quite funny. She could hardly place the symptoms when it happened.  
_

_And the worst part was that it happened just at school. Of all possible places it was the school and not a hospital ... She is in the hospital often, waiting for her mother to finish up her surgeries or paperwork, she had grown up in hospitals, she had colored with crayons on old ER charts, she loved it there ... But the arrhythmias didn't occur when she was at the hospital and waiting for her mother, no it was in high school. In the third period, they had mathematics, she felt her heart rate change in a bad way. It was slower than a normal Sinus rhythm. Meredith felt dizzy at one time. _

_"Grey. Be attentive. I expect you to listen to me, are we clear?" The teacher voiced, irritated Meredith looked up. It was hard to focus ... Finally, the lesson was over. When Meredith and Sadie left the classroom, Sadie turned to Meredith and suddenly said, "You're pretty pale. Has anyone ever told you that, Mer?" Meredith shook her head. "I mean are you feeling ok? Because if you don't feel well, you have to talk to me, otherwise I cannot really help you." Sadie offered her help. She glanced at Meredith and somehow she couldn't shake the feeling that is was her heart causing these problems. Once again ...  
_

_Again she was feeling dizzy. Meredith's class now had PE. She hated 'physical education'. Because that meant changing clothes. In front of wolves aka the other girls in class. "Okay, three rounds of run.", The PE teacher shouted loud and clapped his hands. The classmates started to run with them, Sadie. Meredith joined them, but after several meters, she was unable to keep running. Meredith realized once again how her heartbeat slowed down noticeably. Throw in the dizziness ... "Grey, you are supposed to run." The PE teacher cried from a distance. "I... cannot." She muttered as if to herself, insecure. In the moment even Sadie had noticed that Meredith had not followed her. She stopped and glanced back._

_Another wave of dizziness overcame her and she had difficulty breathing. This wasn't normal. There is no way that these symptoms are normal, especially with her previous medical history. Meredith tried to steady herself, but swayed. Meredith's head was spinning, she tried to take a step but failed. It was fuzzy. Faint voices she could hear. It was so hard to stay focused.  
_

_"Meredith?" She asked as she walked back and stopped in front of her. "Are you okay?", She turned again to her friend. Meredith did not respond. She was in fact not feeling very well and this feeling worsened with every minute. She was feeling dizzy. As in really dizzy, everything was fuzzy. Blurry. Voices were only faint, as if they were miles away. Everything was blurry. Her heartbeat came irregularly. She tried to suck in air but her lungs wouldn't cooperate. She gasped for air, desperately trying to fill her lungs, but failed. In the moment she realized how she slowly lost consciousness. Sadie reacted first. She knew her friend suffered from a life-threatening heart condition and that this state easily can kill her if nothing's done to help her. After a while the rest of her class discovered that something was wrong and came to see what happened._

_"It´s Meri." A boy said. "Looks like she fainted." All his classmates were acting like curious onlookers. The PE teacher was shocked when she saw what was happening and called an ambulance, which should bring Meredith to a Hospital, of course not Seattle Grace Hospital. "Okay, boys and girls. You all go back to the locker room and stay out of way. Let me see what is going on." The teacher shouted when she saw the students crowding something, or better someone. Meredith. And Sadie who was kneeling next to her and called for the teacher. "I need help over here." Meredith wasn't conscious anymore. She was lying on the ground not moving.  
_

_"Oh, God, what happened?" The teacher called out, realizing that one of her students passed out. "She passed out, can't you see that?!" Sadie replied coldly. "You need to call an ambulance right now. Her pulse is irregular and she showed signs of bradyarrhythmia." The teacher looked at her student laying there, limp. Sadie was kneeling next to her and constantly checking her vital signs. Then she positioned her in an airway safe position - which was really important. "We need an ambulance." That's what Sadie heard when the teacher grabbed her cell and called 911. Finally, she couldn't help but think.  
_

_Ellis was being informed that her daughter is on the way to the Emergency Department of Seattle Presbyterian Hospital. Meredith awakened in the ambulance. She had an Oxygen mask covering nose and mouth. __One paramedic was sitting next to her, controlled her sats and heart rhythm. "Hey..." She mumbled, slowly regaining fully consciousness. "Can you hear me?" The EMT asked, as soon as he saw that Meredith opened her eyes. She nodded wearily and closed her eyes. _

* * *

"I would be much more worried about you instead of wondering what the others will think if you show up in their ER as a patient." Derek countered, worry could be seen in his ice blue eyes. Meredith was not on board with that suggestion. "I don't want to go to the emergency department, there is no need to go there ..." Meredith emphasized with a stubborn tone. "You are acting like a little child, who just lost her favourite toy. We are definitely going to the ER, even if you don't want to. If you do not start cooperating, I am calling Cristina." He paused. "And maybe even Burke. Mer, I don´t do ultimatums, normally I don´t, but I love you. Please let me take care of you, Mer."

Meredith pressed her lips firmly together.

"Looks like I don't really have a choice, right?" Meredith realized dejectedly. Derek nodded. As she tries to stand up on her own, she sways and Derek immediately comes to help her. "Sit down." He ordered. He put a helping arm around her waist to steady her. "Sit down." He repeated. Meredith leaned against him, breathing heavily. "Now, if you don't want to faint again. 'Cause you will if you stand up to fast. That's what is gonna happen. Both you know it and I know it." Meredith held on Derek for support as she tries to steady herself. "Good, we've made it to the bed. Almost, only a few meters before we reach it ..." Derek's murmuring gentle words of encouragement.

When she lost balance, Derek grabbed her and supported her until she was safely on her legs. Both sat down on the bed that was only a few meters away. "Is everything ok? Are you still dizzy?" Derek asked anxiously as he watched Meredith attentively. She tried a small and reassuring smile. "I'm okay, my circulatory system was only a little off." She tried to explain. "There is no need for us to go to the ER." Meredith tried to convince Derek.

He did not look very convinced. "Meredith, was if everything's not right? You may think it is, but in reality it really isn't, but we do not realize the fact something's wrong until it is too late." Meredith looked at Derek and said wearily: "I lie down down now. I am kinda tired. We can go to whatever you want but first let me sleep. Maybe it was from exhaustion, you know..." Meredith thought yawning. "Maybe it was just exhaustion, but I don't think you should take this lightly, Mer, but perhaps was also another thing the cause of your syncopation." Derek added wisely. "We are both doctors, Mer." Meredith sighed. "I know that, but I still won't go to the ER because of it. Cristina can run an ECG tomorrow. I am pretty sure she'll do it."

"What makes you so sure?" Derek asked. Meredith rolled her eyes and said: "She did my last echo, because I haven't gone to a ACHD-certified cardiologist in three years. Please, don't be angry with me ..." Derek was taken aback. He did so not expect that. "When?" He asked. "When performed she the cardiac echo? That's the definition of irresponsible, Mer. Three years? Three years between your last echo? That is ..." He wanted to know. "I know, it was risky, but I've had Cristina done one on me a few days ago." "Good." Derek nodded. He was glad to hear that she at least got checked out by Cristina. "Can't we talk about something else?" Meredith asked, she was annoyed about all the talking about her heart.

"Okay, Derek. I did overreact about you telling Mark without even asking if it is okay. But I don´t want to argue anymore. And can we stop talking about my heart? 'Cause it's all we talk about. My whole relationship is about that little detail. Maybe we could talk about you." Meredith suggested, avoiding questions about everything that had to do with her heart. "Why should we talk about me?" Derek asked suspiciously. "Because I realized that don't know anything about your medical history." Meredith answered. "I just know that you like _'The Sun Also Rises'_ among other things."

She remembered when he had shown her the trailer and told her some interesting facts about him (not that he _**was **_married to a neonatal surgeon named Addison Montgomery whom she met only accidentally when she came to Seattle ... not a nice memory if she was honest ... )

_"My mother's maiden name, Maloney. I have four sisters. I have, uh, nine nieces. Five nephews. I like coffee ice cream, single-malt scotch, occasionally a good cigar. I like to fly fish. And I cheat when I do the crossword puzzle on Sunday. And I never dance in public. Um, favorite novel, The Sun Also Rises. Favorite band, The Clash. My favorite color is blue. I don't like light blue, indigo. The scar right here on my forehead, that's why I don't ride motorcycles anymore. And I live in that trailer. All this land is mine. I have no idea what I'm gonna do with it. So that's it. That's all you've earned for now. The rest you're just...just gonna have to take on faith" Derek told her. _

"And, as you said, it's important to know, so do you have any conditions I don't know of?"

Derek looked at her. She seemed tired, almosr overtired. Maybe she just should go sleep. "I was born as a healthy baby, Mer. I never had any serious medical issues as you do." Derek finally answered. "The only time I was admitted in a hospital was when I crashed my motorcycle. But that was an accident." He revealed. "You crashed your motorcycle?" Meredith repeated. "I did." Derek confirmed. "So that's why you have the little scar on your forehead?" Derek just nodded.

* * *

The next day, Meredith met Cristina in the elevator. Derek was with them in the elevator. Derek continued to watch Meredith to make sure she is okay, especially after what happened yesterday. After he left the elevator, Cristina instantly turned to Meredith, who clearly avoids looking at her. "What's the deal with Shepherd? He is constantly watching you, Mer. Does he ..." She whispered to Mer. "Does he know about your secret - y little secret?

"Yes." Meredith replied without looking at her.

"What? He knows? How did he find out?" Meredith sighed loudly. Then she said: "He noticed the scar and then he asked me about it. I had to tell him. I couldn't avoid the topic any longer." "Ah, she is starting to get that avoiding isn't always doing something good." "Shut up." Meredith faked hurt. Cristina was silent, she noticed something was different. Maybe Meredith should tell Cristina about the syncope, because of the ECG, but she did not say anything.

Then chance to tell her was over.

The elevator door opened and they made their way to the intern's locker room.

"But that's not all." Cristina notes. Meredith jumped, startled. "I am right." She stated the obvious. Since Meredith had told her she had kind of a sixth sense when something was wrong with her. Meredith's reaction revealed that she was correct in her presumption. Meredith did not respond. "Oh, come on, you can tell me." Meredith suddenly looked up and said: "I need you to run an ECG on me, Cristina. And don't..." "Why are you asking me to run an electrocardiogramm on you? Explain." Cristina asked. A valid question but Meredith refused to answer it. "Just do it. For your person." Meredith replied. "When I have to run an ECG on you, then I have to know why. And why now? You didn't even want the echo at first."

"Yeah, that might be. But please ... Okay, just forget it."

Then Meredith left the locker room. Dr. Burke was waiting impatiently for her.

* * *

"Grey, where the hell were you? I've been waiting for you." He greeted the intern, then he said: "Well, I looked over your patient's charts and reviewed the the results of the echocardiography, the ECGs and EP study. The EP study showed no pathological rhythms, but the echo concerned me, so I re-did the echo myself and was able to find what is causing the Patient to faint. So what do you see, Grey?" He handed a buch of sonographs to Meredith who stared at those.

Within a few seconds she diagnosed the Patient with pulmonary valve stenosis. Dr. Burke nodded affirmatively and said: "That's what I had in mind. I already talked to the family about the diagnosis. Schedule her surgery for the afternoon and prep her, Grey. You scrub in with me on McGee's surgery. Go prep her." Dr. Burke said.

Meredith nodded. _Yay me_, she thought to herself, she was scrubbing in on a open heart surgery. Cristina would be so jealous if she knew. Meredith prefers neurosurgery as a specialty. But that's not the point. The Point was, she was scrubbing in on a heart surgery on a pediatric patient, it was a great opportunity she for as hell wouldn´t miss although it wasn´t the first pediatric heart surgery she scrubbed in on.

On one of her very first days, she noticed a newborn in PEDS turning blue for a few seconds. But when she listened to the infant´s chest she heard a murmur, from which she was told that something wasn't as it should be. But the resident didn't believe her, even Dr. Burke did not do anything, just asked if PEDS wanted a consult and when she told him that they don't, he ordered her to let it go. But she remembered the time she was there. Her ductus had closed and she declined rapidly. They almost lost her. She wanted to make sure that that baby's okay.

But she didn't. A newborn's life depended on her. She couldn't just let it go. Not when a baby's life depended on her. So she talked to the parents of the little boy herself. When the peds resident saw her doing that, she went to get her superior. She almost got in real trouble back then. But Dr. Burke saved her. It was now her patient and her responsibility. The boy's diagnosis was pulmonary atresia with intact ventricular septum. Through tricuspid valve insufficiency the right chamber emptied itself. The right chamber was due to the atretic pulmonary valve hypoplastic. 'Peach pit ventricle', surgeons call that.

* * *

In the scrub room before surgery, Meredith was standing there, washing herself sterile while Dr. Burke opened the door and nodded to her. Before Dr. Burke and Meredith started the procedure on the teenage girl, he started asking her question about the medical condition they´re about to correct. "Before start operating, you´ll have to answer some questions, since this hospital is a teaching hospital." Meredith nodded shortly and quickly replied: "I know, Dr. Burke, that I am here to learn to become a great surgeon."

The cardio-thoracic surgeon nodded approvingly, before asking: "What can you tell me about pulmonary stenosis?" Meredith said: "Well, pulmonary stenosis can occur in older children and in infants, sometimes it is a isolated stenosis, means that there are no other defects or it is associated with other heart conditions. The symptoms can be quite severe or the patient could be asymptomatic."

"What are the common symptoms of a pulmonary valve stenosis?" He questioned her. "The common symptoms of..." Meredith repeated, then she answered: "Symptoms include jugular vein distension, cyanosis, and general symptoms of lowered oxygenation of the blood. If it is severe, sudden fainting or dizziness may occur when exercising. An enlarged liver (hepatomegaly) and edema may also be apparent."

"Good, what about degree of the stenosis? And how do you diagnose this?" Dr. Burke asked, before he got ready to enter the operating room.

Meredith answered after a few thoughts: "You diagnose with degree of stenosis is typically determined by the peak pressure gradient across the valve. Pulmonary stenosis is mild if the valve area is larger than 1.0 cm2 per square meter and the trans-valvular gradient is 30-50 mmHg, or the peak RV systolic pressure is less than 75 mmHg."

Then she added: "The stenosis is moderate if valve area is 0.5-1.0 cm2 per square meter, trans-valvular gradient is 50-75 mmHg, or right ventricle systolic pressure is 75-100 mmHg. It is severe when the valve area is less than 0.5 cm2, and the gradient is more than 75 mmHg."

"So why are we doing a valve replacement?" He asked. "Because the stenosis is on the valve, not on the vessel."

"Good, Grey, get ready and scrub in." Meredith nodded, and when she she was ready, she entered the operating room. Dr. Preston Burke was about to start the median sternotomy to divide or crack the sternum. But then he decided that Meredith should open open up. His interns should be learning something. "Here, Grey. It's your turn." he announced. Meredith did'´t expect that. She'd thought maybe she would hold a clamp or suction, but certainly not open up.

It was a welcomed surprise.

"Really? You're serious? I am gonna do the vertical inline incision along the sternum?" She exclaimed excitedly.

"Come on, Grey, before I change my mind." He just answered and handed her the scalpel. Meredith's heart raced when she took the scalpel and she kept telling herself 'Don´t screw this up, Grey, don' screw this up ...' You're extraordinary, you're a survivor. She took a deep breath, and made the first cut. It wasn't that difficult considering you could see the scar from the previous surgery.

Then she handed the scalpel back to Dr. Burke, who nodded approvingly as he glanced at the cut in the middle of their patients chest she made with the scalpel.

"Sternal saw." He ordered briskly and the OR Nurse handed him the sternal saw. He began to divide Lily's sternum. Meredith watched the procedure closely. Meredith quickly followed the instructions, in the next minutes Dr. Burke will replace the pulmonary valve with a tissue valve.

Meredith watched the procedure closely as she realized her heart suddenly began to beat irregularly. Oh, no. Come on, not now. Keep your shit together, heart, please. Not yet. Not when she is in surgery. Her heart skipped a beat or two. Why does this happen actually always when she was in the OR? She did not understand it, why was the universe so freakin' screwed up. Hm? Anyone care to answer? Of course not.

Relieved, she could feel her heart rhythm somewhat returning to normal, back to sinus rhythm. "Grey concentration." Dr. Burke Meredith overlooking the heart of the patient warned directed. Meredith replied laboriously: "Yes, Dr. Burke." The young soon to be surgeon hoped that her heart will soon cease to stumble ... Skipping beats, beating irregularly. A few minutes later saw on Dr. Burke, by the way, he noted that something was different. "Grey?" He asked. Meredith looked up. "Yes?" Her blue eyes focused Preston and she waited for him to continue.

"Is everything okay?" Simultaneously he noticed how pale she was waiting for a response from Grey. "Yes, it's all okay again." She replied. Without thinking ... "Again?" Dr. Burke commented confused.

"My heart ... I don't know ... it skipped a beat or two. For a few seconds it stopped." Meredith replied without thinking.

Now she had undivided attention of Dr. Burke. Definitely ... "Skipped a beat or two? Are you sure?" Dr. Burke was alarmed. Skipped beats were almost always a sign of something bigger. They were trouble. "Did that ever happened to you?" Meredith registered only now, what she had done. In Thoughts Meredith replied, of course it happened... But when asked by Dr. Burke, she replied not really. "It is all under control." She lied. "If you say so, Dr. Grey." Skepticism sounded in his voice, he recalled Cristinas research about CHD and surgical procedures - but he said nothing. After several hours, the surgery was finished and proud Meredith left the operating room.

The operation was flawless and soon Lily was back in stepdown unit. Her vitals were good, as to be expected after such a surgery and there was no need for her lying in CICU. Lily's mother was more than relieved when she heard that her daughter was out of surgery and doing as well as she could. "Do you want to go sit with her?" Meredith asked empathetically. "Yes, please. Bring me to her." Meredith watched the mother glancing at her lovingly.

"Mum?" A hoarse voice asked. The mother lit up within seconds.

"Lil, oh, you're awake. God, I ..." She turned towards Meredith: "Thank you for everything you've done for us."

Meredith just smiled and left the room to let Lilly McGee recover from her surgery. Not knowing that she'll be post - op in a few months too ... But back then she didn't know. And she was glad about that.

* * *

**A/N: ****_Hey, there. Thank you for reading. _**

**_Pulmonary atresia with intact ventricular septum (PA/IVS) refers to the absence or underdevelopment of the pulmonary valve and the absence of a communication between the lower two chamber of the heart (ventricles). The pulmonary valve ring and main pulmonary artery are hypoplastic (underdeveloped) due to lack of blood flow in utero. This means there is no direct communication between the right ventricle and the pulmonary artery. The only source of blood to the lungs is supplied by the ductus arteriosus, a normal fetal structure that usually closes in the first week of life. PA/IVS is often associated with coronary anomalies, such as obstruction or absence of the proximal or left coronary artery. The right ventricle (RV) size varies and portions of the right ventricle may be absent. The muscle (myocardium) of the right ventricle (RV) is often abnormal. PA/IVS accounts for less than 1% of all congenital heart defects and 2.5% of all critically ill infants with congenital heart disease._**

**_Pulmonary Valve Stenosis__** is a heart valve disorder in which outflow of blood from the right ventricle of the hea**rt is obstructed at the level of the pulmonic valve. This results in the reduction of flow of blood to the lungs. _**_**When the pulmonary valve is obstructed, the right ventricle must work harder to eject blood into the pulmonary artery. To compensate for this additional workload, the muscle of the right ventricle gradually thickens. The thicker right ventricular muscle, known as hypertrophy, is rarely a problem in itself, but instead is an indication that significant valve obstruction exists. **__**In an older child, severe pulmonary valve stenosis may cause easy fatigue or shortness of breath with physical exertion. Severe pulmonary valve stenosis rarely results in right ventricular failure or sudden death.**_

_**Stay tuned for the next chapter ...**_


	9. Chapter 9

**Chapter 9**

* * *

**There comes a point in your life when you're officially an adult. Suddenly, you're old enough to vote, drink, and engage in other adult activities. Suddenly, people expect you to be responsible, serious... a grown up. We get taller, we get older. But do we ever really grow up? In some ways we grow up. We have families, we get married, divorced, but for the most part, we still have the same problems that we did when we were fifteen. No matter how much we grow taller, grow older, we are still forever stumbling, forever wondering, forever.. Young. **Meredith; Forever Young

* * *

"Meredith." Derek called after her as soon as he saw her. Meredith turned around and faced Derek. "What about your..." Before he completed the sentence, he looked around to make sure nobody hears what they're talking about. "... ECG? Did she run one on you, Mer? Did she? Please tell me she did." He wanted to know. "No, I had no time for it." She explained, her voice was a bit hectic. "So why didn't you? Why didn't you make time? It's your damned health, even if you don't want to hear it." Derek continued. "You might not care, but I do. I do care, very much, actually. I do care about you. And it's important to get this checked out. I mean fainting spells in adults and children with congenital heart defects have dangerous potiential to get life - threatening, Mer, and you know. Even if you don't want to disavow this. You have to get yourself checked out. I now regret that I haven't called an ambulance. If I did and you got checked out, I would be feeling far more comfortable than I am feeling right now." Derek looked at her, Meredith avoided his gaze.

"I was in the OR, I didn't have time for it." Meredith tried to convince him. She didn't look him in the eyes as she talked to him. She was clearly avoiding his gaze. "Well, it seems like I have to do it myself. I have to page Cristina to let her do the damn echo." He said after thinking. "What ... why?" Meredith asked, slightly overwhelmed. Her heart rate sped up, her pulse was racing. "That question, Mer, wasn't necessary. You know exactly what I am talking about." He just replied. "Or are you gonna tell Cristina what happened yesterday?" She winced slightly. "Yes, I am. She's my person, remember?" She gave back, her eyes sparkled. Derek did not reply. He grabbed her arm gently but determined, so that she has to follow him as he begins searching for Cristina. She was talking to Dr. Preston Burke, but when she saw the urgency written on Derek's face, she said something to Dr. Burke, who nodded and then left. Cristina instantly knew it had to do with Meredith. With that look, that horrified, worried look on his face it was more than clear that that was about Meredith Grey and her current state.

"Tell her." Derek whispered.

Meredith just breathed. She didn't say a single word.

It was perfectly quiet in the hallway. There were no codes, no nurses running around or doctors with big ego complexes running around, just Meredith and Cristina and Derek were standing there. Nobody talked. Derek waited for her to start talking. She should be the one who tells Cristina. A few seconds passed. Then another few seconds. "Meredith? Is something going on, why is he looking like he has lost his puppy?" Cristina asked worriedly. "What happened? Why won't you look at me? There is something, right? I know you. You are experiencing symptoms, am I right? Speaking of which, why did you ask for an electrocardiogram?" Derek looked up. She is starting to get it. "I don't understand." He said finally. "I thought you did not ask for an ECG." Cristina looked between Derek and Meredith back and forth. They were hiding something, one little important detail that is neccessary for her to get what is going on.

"Okay, now you've lost me." She said dramatically and eyed Meredith.

"So, why the sudden need of an electrocardiogram? Meredith, if something going on, you have to ..." She started, but was being cut off by Meredith who stubbornly said with a hight - pitched voice: "I know that, I just don't want to talk about it. You can't make me." Cristina sighed. Meredith Grey was an avoider, she avoids instead of facing her problems. But this was definitely bigger than some screwed up relationship or something. "Meredith, we all know you're the queen of avoidance. That we know, but at some point it has to stop. You can't keep doing this. They will find out eventually. Also, it's not good if you're not honest. That behavior can really bite you in the ass. Even if you think your problems are solved, they will come crawling all back to you when you turn your back. This is not doing anything good, believe me." Cristina made up a speech.

"Now spit it out, Grey." Cristina ordered.

"What should she spit out?" Out of sudden Alex appeared on the floor. He glanced at Meredith and Cristina, he ignored the fact that Dr. Shepherd was standing right behind them and he was suspiciously eyeing Dr. Karev aka evil spawn.

"What's up, guys." He looked at the three and smirked cockily. "Am I interrupting some of Meredith and Cristina's 'Freak out- time'? Sorry for that." He spoke, still smirking. Cristina and Meredith stopped dead in their tracks. Time didn't matter anymore. Nobody said anything. Derek silently clenched his fists. Cristina couldn't believe it. What was he doing here? Isn't he supposed to be somewhere else? Meredith wished she would disappear. In the ground, in this very second. Her thoughts raced.

Damn it. Why he is here right now? If he knew about it it would disastrous for all of us ... He could get us all in real trouble. Oh, no this was not good. So, so not good.

What if he has overheard what we were talking?

"None of your damn business, evil spawn." Cristina hissed sharply unable to control the intensity of her voice, before he had the chance to add something. She glared at him, adrenaline was shooting through her and her heart quickened slightly. She looked at Meredith, for a second then she turned back to Alex. "Why are even more pissy than normal, Yang?" Alex shot back, while rolling his eyes. He was still smirking like an idiot. "Just try to disappear. Now, or I will kick your ass, so that you wished that you would have never been born." Cristina claimed, her voice rose slightly, who was not happy to see Karev keep getting on their nerves with his attitude. She just hoped he had heard nothing from the ongoing conversation - which is highly unlikely but you never know for sure -

"Just drop it and leave. This is none of your business."

_Then we will have a real problem._

_´Cause he will probably go to Bailey._

How she will come out of this situation back out without anyone paying attention what was going on?

_Then I will have a big problem, because I didn't tell anyone._

_It's reckless, I know, but still it is my choice. We live in a free world. It is my choice.  
_

Alex laughed.

"Make me." He said, keeps on laughing. Derek cleared his throat, Karev really was getting his nerves and he decided to do something about it. Otherwise, they still be here tomorrow and Derek did not intend of that becoming reality. So he took over the management of conversation. "Karev. Don't have you something to do? Like patients or running labs? I am an attending and I am telling to shut up and freaking do what you are supposed to do. And heck, stop listening to other people's conversations, it's rude." He asked sharply. Only now seemed Alex to notice the neurosurgeon and jerked up startled, as he heard the strained voice of the neurosurgeon of Seattle Grace Hospital.

"Ye... yes, Dr. Shepherd." He stuttered, unsure. "Then do it. Go do medical related things like charting, running labs or do patient consults. If you have nothing to do go find your resident. I am sure she will give you something to do. ´Cause I think your pay cheque covers more than standing around and listening to other conversations. You get paid for being a doctor. Or I will report you to the chief or Bailey who will make your life a living hell, believe me she does."

"To whom? Dr. Bailey is not afraid of you." Alex replied.

"You did not..." Cristina spoke up.

"He's an attending. He has the power to ban you from the OR for weeks."

"I know McDreamy is an attending. And Meredith's been sleeping with him anyway so what's the big deal?" He emphasized the word 'McDreamy'. How could he possibly talk like that to an attending? What is he doing? If he continues that, he will not see the inside of an OR for weeks. And hell, yes he would deserve that. Derek gasped when he heard him talking like that. His bood boiled and his insides twisted. He was far too shocked to react. Meredith on the other hand, sprung into action.

"Alex. Just stop it or I beat you to pulp with my tiny, ineffectual fists. Don't talk to him like that ever again. Did you seriously just say that? What the fuck, Alex? Are you out of your mind, your tiny, little mind? He can end your career. Stop it or I'll do it. I'll slam you against the lockers, I've done it before." Meredith ranted and glared at him angrily. "And I think Derek will let me do that this time. So just do what he says or you´ll end your career as a surgeon before it even started." Alex shrugged and disappeared over the floor. Before he leaves he mumbled something that sounded like an apology.

"Now, Meredith, what happened?" Cristina asked.

Still, Meredith said nothing about what happened. Derek sighed. "Okay..." He said with a sideglance at Meredith who was very interested in the ground. Then he revealed what happened yesterday: "She passed out. She fainted during a fight. Her heart couldn't take it." For some endless seconds Cristina just stared at Meredith. Cristina was silent, she needed a minute to process everything. After seeing her facial expression, Cristina knew Derek was telling the whole truth. "Why didn't you tell me?" Cristina was shocked.

_She what ..._

"I... I..." Meredith stuttered helplessly.

She took a deep breath.

"Remember when I told you to run an ECG on me?" Meredith asked. Cristina nodded. Yeah, she remembered that. "But still, you didn't tell me back then." She stated worriedly. "Why didn't you just came to me for help. I would have done it in a moment. You just ..." Meredith looked up. "But I was going to. When we were alone and not in a freaking elevator." Meredith said in response. "Whatsoever, can you run the ECG now, please? Otherwise Derek will never stop hovering."

"He hovers?" Cristina repeated, she had to hold back a laughter. "Nah, have fun with that." "I am Standing right here." Derek interjected, didn´t want to deepen this topic. Both Meredith and Cristina ignored him. Cristina chuckled for a second. Then she got serious again. "Okay, then let's do the ECG."

"What about an echocardiography?" Derek wanted to know.

Both women turned around. Derek asked the question. "We already did one a few days ago." Cristina explained. "Come on, Mer."

"You have to do another one. Something could have changed and we don't know about it before it's to late." Derek demanded. "But I am her medical proxy and I ..." Before she could finish her sentence, Meredith interrupted. "Okay, let's be clear. I am capable of making decisions on my own. I am breathing, I am talking and my heart is beating in regular sinus ... I am not unconscious where you make these decisions. Right now, I can do them on my own." Both of them quieted down in a heartbeat. Meredith scolded them: "What is wrong with you guys? I am standing right here - and you two have nothing better to do than arguing about whether I should get another echo or not. Doesn't it sound weird? Because it does, it is weird. What is wrong about doing another echo, I mean there is no need to worry about anything." Meredith watched them with amusement.

"And just for record, in case you've been sleeping during my speech about being awake and conscious and alive: I am perfectly capable of doing these decisions for myself." Meredith stated. "Okay, I'll let you do another echocardiography. Let's get this over with." She decided. "Derek can come with us." A hint of a smile can be seen on Derek's lips. But he is worried.

Derek's heart was racing. in the next few minutes he will see the heart of Meredith on. He told himself on a continuous basis that it is just a normal cardiac echo, as he had seen them often as an intern in the time as surgical resident. But that's not it. Mer's heart is not healthy. It's not. _It's not._ That is a fact. God, he did not expect to be that nervous. But he was, probably he was worried about Meredith. Healthy People don´t faint out of sudden.

When Cristina grabbed the transducer, Meredith reached for Derek's hand for support and closed her eyes. She knows what her heart looks like. She has seen it like a million times. Derek squeezed her hand and then looked at the screen only to see a beating heart. But not just from any random patient, it is insignificant to say that cardiothoracics isn't even his specialty.

It is Meredith's heart. It is her beating heart on the screen. Derek could not believe it. But he also saw the shunt, the blood flow between the left and the right ventricle with each beat. There was right - to - left / left - to - right - shunt. There was abnormal blood flow. His breaths came in short, desperate gasps as he understands the finality of this situation. The situation Meredith was in. Then, when Cristina clicked on 'motion mode' they heard Meredith's different heart valves. Derek stared at the monitor. This wasn't fair, Mere doesn't deserve any of this. She is supposed to be healthy.

* * *

It has been one and a half month. One and a half month and still nobody know anything about the situation that was coming. It will be a shock to them all. Bailey seemed to sense something was wrong 'cause she kept watching her. Maybe she has something like the sixth sense. It becomes much more difficult for Meredith to prevent anyone notices that something is wrong with her, because her condition worsened over the months. As in really, worsening. Aortic stenosis is a progredient disease which means that it's only gonna get worse than it already is. She's getting presyncopes more often. She fainted when it was really bad. She is not nearly as physically fit as before. She knows it, Cristina knows it and Derek knows it too, but Meredith clearly is in denial. She thinks she doesn't need surgery. To correct it.

_Denial._

_It's what brings us through our internship._

Meredith is very often assigned to Derek's service, and he also knows her limits. Mostly because he knows her limits, how much strain her body can take. Derek made sure that she took enough breaks and that she drinks enough to stay hydrated. He knows what heart can take, but she also likes being in neuro. Cristina also did a repeated echocardiography to see if the aortic stenosis has gotten worse over the months. It did, actually, even if she did not want to admit it. It was a Monday morning, Meredith was getting ready for work, already running late. "Meredith. We are going to be la ... ate." Izzie's penetrating voice was clearly indicating that they were in fact running late. "Coming." Meredith rolled her eyes at Izzie and was about to go downstairs when she got hit by a sudden wave of dizziness and was fighting the sudden urge to vomit.

_No, where was this coming from?_

_She hadn't had a circulatory attack in months ..._

_Why is she having one now ... God, just make this stop.  
_

"Meredith. Are you coming? Bailey's gonna be pissed if we're not punctual, you know how she is." Izzie called upstairs, slightly annoyed that she and George have to wait for her. Meredith however did not answer, she had enough to do to keep the intents of her stomach down. She ran back to the bathroom and looked the door in time. She started throwing up right after she sat on the floor next to the toilet. Hopefully the others won't come up here, worried about her and what's taking her so long to simply go down the stairs. But she was feeling sick. Mer's head was throbbing and her pulse went crazy. She was dizzy, she wished Derek was here. Telling her, she would be okay. Immediately a dull and pulsating headache set in. Meredith groaned suppressed, hoping this would soon end. It's best just to ride it out.

There isn't very much she could do anyways. So she just let's it do its thing.

"Meredith whatever's taking you so long ... I am coming now." Izzie was getting worried, repeatedly Meredith groaned and buried her face in her hands, ended up rubbing her temples and trying to not puke her guts out. Then the sick and nauseating feeling in the stomach appeared again causing her to hurl again. When Izzie heard those weird sounds, she knocked on the bathroom door and asked: "Meredith, answer. Are you in there?" She wanted to know.

"No, I am hiding under my bed." Meredith replied ironically, almost sarcastically ...

"Come on, Mer. What the hell is taking you so long?" Instead of answering, she only heard a soft moan coming from behind the door. Now she is concerned. "Are you okay, Mer? Are you ill, if you are, you need to stay home." Izzie exclaimed. "Are you." From behind the door, she heard water running and then ... Suddenly the door opened and Meredith appeared in front of Izzie, her face still drained from any colour. She was still experiencing a bit of laboured breathing as Izzie occured in the door.

"My god, what happened to you, Mer?" Izzie exclaimed as soon as she noticed her unsteady balance and her pale and bloodless lips. She was concerned the minute she saw how wobbly she was. "Nothing serious, Iz. Calm down, I am not going to pass out..." Meredith said. Izzie continued to contemplate Meredith's appearance. "Nothing serious? Mer, you look like you are going to faint any Moment. What is going on. And don't say 'I am fine', 'cause then I might consider killing you for that 'cause that's utter crap."

"It's just the flu. It is probably a twenty four hours thing, nothing more." Meredith said nonchalantly.

She just shrugged it off as if it was nothing.

But it was her circulatory system telling her to slow down, to do something to prevent that aortic stenosis from progressing. Maybe, the next time this happens, she will be lucky when she's not losing consciousness. Meredith knew it was more than just the flu. _She knew._

"As if I going to believe that. You're as pale as a sheet. Just look at you. You are in no condition to work today." Izzie tried to convince her. But Meredith Grey was stubborn, as always she didn't see the benefits of her staying at home. "What's the holdup?" George called up, his voice strained. George was getting really impatient. "Meredith's sick." Izzie shouted back. Loudly. What is not really helping with the pounding headache that was still there. "What? I am not." Meredith protested weakly and tried to shove Izzie aside, 'cause she was kind of blocking the stairs. "We're gonna be late." Meredith reasoned. "You are supposed to stay in bed and recover." Izzie didn't give up, the blonde doctor still tried to persuade her that staying at home is better for her.

"I am a doctor and we don't take a day off even when we are sick, so just drop it."

"Fine." Izzie huffed.

Without another word, Izzie turned around and headed down downstairs. Meredith took a deep breath and followed her. Izzie was driving, Meredith sat down in the back, relieved that she doesn't have to drive. Mer pressed her forehead against the cool window, for a moment she closed her eyes. "Mer." Izzie. "Are you sure your okay? I mean you don't look good." "I am fine." Meredith replied. In the hospital, it smelled like disinfectants and overall, like a sterile environment. She met Cristina and Alex in the interns' locker room. Meredith was getting dizzy again, but thankfully her pounding headache diminished at some point, so she could think straight. Only the dizziness was reoccuring and still there. Meredith quickly sat down on the bench between the locker and waited for the dizziness to pass.

Izzie shot her a look. ´Told you, you should have stayed at home, but you weren't listening.´

Meredith rolled her eyes at her friend and turned towards Cristina, who glanced at her person with a scanning doctor glance. "She's right, you really don't look good. You look sick, why are you looking sick? Because you are. Are you pushing through?" She said then, almost rambling. "Cristina." Meredith interrupted sharply and Cristina understood. She waited until the other interns were gone and then looked expectantely at Meredith. "Is it the flu- thing?" Cristina asked.

Meredith shook her head. "No, it is not. I don't feel flu- ish. My glands aren't swollen. It's definitely not the flu. I think it's..."

"... food poisoning?" Cristina pondered.

Meredith did not think of that possibility, but she was pretty sure the reason she was not feeling well is another. "Or are you ..." She didn't finish the sentence, Meredith got what she meant anyhow. "I am not pregnant. I've had this before, though it hasn't happened in a long time." She trailed off, stared at some lockers. Cristina let it sink in, then she said: "You mean, it has something to do with your heart?" "More like my circulation. I think it's my circulatory system that causes all these random symptoms." Meredith tried to explain. "So you mean you have a circulatory attack or circulatory collapse."

"That's what I am saying. What I am trying to tell you."

"Oh." Cristina said not quite sure what to say to that. But before she could respond to that in any way, Dr. Bailey was standing in the door frame, looking at them with an unreadable expression. "Grey, Yang, what are still doing here? You are supposed to meet me and the other interns at the nurses station. Now, go, before you stuck in the pit all day." She ranted. Meredith and Cristina quickly stood up and followed their resident. Meredith was more than relieved when the dizziness didn't occur then. Bailey would have noticed within seconds. She knew she would.

* * *

"Grey, you cover the pit." Dr. Bailey ordered. "Yang, Dr. Sloan. Stevens, you shadow Dr. Yang and O'Malley, you´re with me. Karev, Dr. Shepherd needs an intern on his case. Let's go. Move people. There are lifes that need to be saved. Go." "No, I hate Plastics." Cristina complained loudly, trying to get a cardio case. She wanted in on some of Burke's cardio cases. Dr. Miranda Bailey just snorted before turning to Cristina. "Do I look like I care?" Dr. Bailey asked rhetorically. All the others were staring at her as if this was some kind of cinema. Alex whispered something to Izzie but Bailey silenced them with a glare.

"Honestly, no." Cristina answered.

"Good. Looks like you still have some brain cells to think with. I am glad you use them. Now take your brain cells to find Sloan. I am sure he doesn't have all day long time to wait for an intern. Now, go. Sloan is waiting for, Yang." Dr. Bailey countered. Cristina pressed her lips together and said nothing. Meredith made her way to the emergency department, without even thinking about complaining to Dr. Bailey. It was quiet. Of course she didn't say that loudly. If she did, she would have jinxed it. Then there was a change of plans. "Grey, wait." Dr. Bailey called after she entered the pit. She saw Meredith leaning against a wall, waiting for patients obviously not feeling well. An alarm went off in her and she decided to talk to Grey.

"Grey." Dr. Bailey repeated.

"I need to talk to you."

"Why?" Meredith asked, her voice tense.

"Dr. Montgomery is requesting you for a case. I got O'Malley covering the pit today. Go. She is waiting for you in the Neonatal Intensive Care Unit." Dr. Miranda Bailey adressed her young intern. Meredith just nodded and then left to go to the NICU. Meredith turned and was about to leave when she heard Bailey call her back: "Grey. Wait up." Meredith stopped and turned around, facing Dr. Miranda Bailey. "Are you okay?" She asked. "Just so you know, I haven't gone soft." Meredith replied with a standard answer aka I'm fine. "Really?" Bailey didn't sound very convinced. "Sure." With that Mer left.

On her way she met Derek.

"Mer, wait." He called after her. "What do you want, Derek. I am perfectly fine. Really. You don't have to worry about me. I am _fine_. Go do neuro things. Go be the great neuro god you claim to be." Meredith replied. "'Cause I have to go. Your ex wife is waiting for me to show up in NICU." "Where?" Derek couldn't not ask. "So much to you listening. Neonatal Intensive Care Unit. Addison requested me for a case. Oh, and have fun with Alex, he has quite a big mouth sometimes." Meredith could not help grinning. "So I noticed." Derek kissed her. "Not here in the hallway." Meredith said when they stopped.

Meredith entered the Neonatal Intensive Care Unit. She found Addison Standing next to an incubator and she inserting a feeding tube. Or at least she was trying to, but failed. Then she gently passed a catheter into the esophagus to check for resistance. "Damn it." She murmured quietly, looking at some numbers. "Looks like an EA to me." Then she was listening to the baby's heart and lung sounds. "I am here because you requested me. How can I ..."

"Ah, Grey, nice of you to join me today. So this is our patient. She was born a few hours ago. She presented with drooling and that is frequently accompanied by choking, coughing and sneezing. What do suggest?" Addison asked Meredith, who was absently watching the infant. Recalling baby pictures of her lying in that incubator, trying desperately to survive. _Fighting to even get the chance to live._ "Grey." Addison nudged the young intern on her shoulder. Grey awaked from her stupor and started rambling: "Sorry ... I wwass ... sorry, it won't happen again." Addison nodded. Meredith immediately recalled what she knew about esophageal atresia.

"Well, I would do some tests to rule out esophageal atresia. The symptoms are fitting. I would do a chest radiography including the upper abdomen with reclining in the upper esophagus pouch. If there is air in the abdomen, it must be present (lower fistula, type IIIb example) to connect to the gastrointestinal tract. Is found a "hermetically empty abdomen", then it is usually a type II." Meredith ended, her gaze shifting to the infant, then to the heart monitor that was beeping steadily. The light was slightly blue dimmed in here.

Addison nodded approvingly and asked the young intern, who is on her service today: "What can be be watched? What are the symptoms and the clinic?" Meredith knew it.

"When fed, these infants swallow normally but begin to cough and struggle as the fluid returns through the nose and mouth. So it's discovered soon after birth, when the Infant is unable to swallow its own saliva. Sometimes it can also be discovered in a prenatal ultrasound." "Well, the mother's pretty worried, so should probably go and talk to her since we have stabilised the newborn. Before that, schedule a chest and abdominal x-ray and then come and find me." She handed Meredith a patient chart.

Meredith took the chart and looked at the name: _Molly Grey - Thompson._ Why does this Patient have the same surname as her? Meredith knew that her father had left her, before she was even born. So he had a new Family now. Meredith didn´t know what to do. This patient might be her sister or half-sister. Unknown half-sister.

Suddenly she felt a little dizzy.

_God, not now. I am at work. _

_I cannot pass out now. _

_Please, someone make this Feeling go away. I can't take it anymore. _

Meredith leaned against wall, she was breathing heavily. After a minute or two the feeling passed. Cristina made some notes in a chart of one of Sloan's patients, who was here for a face lift. Absolutely boring. Then she saw Meredith, who honestly wasn't looking so good. She was more pale than normally. Cristina walked over to her friend. "Mer? What's wrong?" She asked concerned, knowing her person all too well.

"I am freaking out. I think I have a half-sister." Meredith answered and showed Cristina the name on the chart. "Wow." Cristina's reaction came almost immediately. "Did you know about her?"

"Of course I didn´t know I had a half-sister. My father disappeared before I was even born. I don't care about him or his stupid new family. He did not want me. Yeah, nobody wants a sick kid. As simple as that." Meredith ranted, she was hurt that her father did not choose her instead of his new family. _Nobody wants a sick kid._

"Meredith, you think he knew?" Cristina interrupted._ That I was born with a CHD? Maybe._

"I... I don´t know. Maybe it is genetic, because I know that my mother has no relatives with heart defects. So maybe it really is genetic and it is his fault that I have a heart defect ..." "Stop it, Mer. You are making yourself crazy. You're rambling. And do you really want everybody to know about it? Because that's what´s going to happen if you keep your voice this way." Meredith stopped. "Just try and breathe. In and out. In and out." Cristina coached her friend. After awhile Meredith was okay again.

"Thanks, I'm good now."

"Sure?"

Meredith nodded. "You probably should get going."

"You're right." Cristina left.

* * *

She should really get going and schedule that damn roentgenogram for her patient. After she did that, she paged Dr. Addison Montgomery while she was waiting for the results to come up on the monitor. "You paged. You have the results now?" "Waiting for them to come up." Meredith responded, she directed the view of the monitor. "The images are up." Immediately both doctors glanced at the Screen. It showed a Esophageal Atresia with proximal TEF (tracheoesophageal Fistula). The upper esophageal pouch connects abnormally to the trachea. The lower esophageal pouch ends blindly.

This baby has esophageal atresia and they should operate as soon as possible.

"Let´s book an OR." Addison said. Meredith nodded and without saying anything, she reached for the for phone. "Now we have to talk to the mother. Let's make it quickly, the sooner we get her to an OR the better."Meredith and Addison Montgomery entered the patient's room. The mother wasn't in her best state. She was worried. Very worried and she had tears running down her cheeks.

"Your baby girl has a condition called esophageal atresia. It means her esophagos ends blindly and she is choking on her own saliva. We need to get her into surgery right now. We just need your consent."

"Do whatever you have to do to save my baby girl." The mother said, her voice breathing. An elder woman soothed the baby's mother, she was obviously the grandmother. Meredith eyed the patient and the other woman. So that's her father's new family. Does he even know that she exists? Maybe Thatcher doesn't even know about her existance.

After Addison talked to child's mother, the child was prepared for surgery.

* * *

Cristina stared at the OR Rotation, she was standing near the nurses station. Dr. Burke was doing a OPCABG in OR4. OPCABG is short for a surgical pro called Off-Pump Coronary Artery Bypass Grafting. They were operating without using CBM to to bypass heart and the lungs instead of operating on-pump. She sighed. She could not convince Burke to let her scrub in on this one. Instead of her Izzie scrubbed in.

Even if Izzie just was flirting with cardio and not married to it like Cristina is. Dr. Bailey tore her intern roughly out of thought. "Yang." She called. Cristina turned abruptly and stood in the face with her Supervisor. "Dr. Bailey. What can I do for you?" She asked, seemingly nervous. For some endless seconds Dr. Bailey looked at her with a penetrating look. For Cristina it was quite uncomfortable, she wondered what she could have made wrong. "Dr. Bailey, what can I do for you? Labs or charting?" She finally asked.

"Come with me." She simply said.

"Where are we going?" Cristina asked. "The chiefs office." Bailey simply answered Cristina's question. "What? Why? I didn't do anything. I did not do anything wrong, I never made any mistakes, my work was flawless." Cristina protested. Dr. Bailey shut her up with a glaring stare, which would have killed her - if looks were able to kill. Dr. Richard Webber waited for them. "Yang. Bailey. Come in." He said. Cristina did not know what this here should be or how it would end.

The door of the office closed. She was alone. Along with Dr. Webber and Dr. Bailey, who were both looking at her. "Now, Yang..." The Chief began, then he cleared his throat. "What did I ... Did I do something wrong? Will you fire me?" Cristina autimatically feared the worst possible Option. "No, it is nothing like that. But I want you to explain a few things to us..." He continued. Dr. Bailey was standing behind Dr. Yang. Her facial expression was unreadable. She had her arms crossed over the chest. Cristina didn't know what she could have done wrong, if she had done something wrong anyway. She couldn't think of anything that she might have done wrong way.

_Oh, no. That can't be good._

_Hopefully it's not about Meredith..._

And Cristina was right. The question was about ... Meredith, of course. They would find out eventually. She had told Mer that a million times and she is going to blame her. "Tell me what you know about Grey's medical history. And don't lie. Don't even think about lying. Don't say, I don't know what you are talking about. ." She advised. "Then you would be lying, in fact. I've seen you and Grey. She looked like she was going to collapse." She trailed off. "So, what is really going on?"

Cristina exhaled sharply. No, this wasn't fair. It wasn't fair to corner her like that.

_Crap._

_What am I gonna do?_

_I can´t tell her. _

_I promised Meredith that I won't tell..._

"Yang, I am waiting. We are waiting." Dr. Bailey sounded slightly impatient. "I know you two are very close, so there is a great chance you know something about your person´s medical history. Spit it out. I don´t have all day." "She´s right. We´re just worried about her, Yang." Dr. Webber cut in. "She is like a daughter to me. She is the daughter I never had."

Awkward silence followed.

"Or I can ban you from the OR for for an indefinite period." Dr. Bailey threatens. "It is your choice." Cristina remained quiet, it was for the better. "It is up to you. What are you gonna do?" Dr. Bailey said from behind. Since when ultimatums are allowed at work? Cristina shifted uncomfortably, but did not say anything. This situation was unbelievable. Time flies...

_Crap._

_What am I gonna do?_

_This is torture._

_She cannot do that or can she?_

* * *

_**A/N: Hey, there. Thank you guys for your reviews. It means a lot. Sorry for the major delay.**_

_**An Esophageal Atresia, short EA, is a congenital defect which affects the gastrointestinal System, it occurs together with heart defects or tracheoesophageal fistulas short TEF. **__**With this condition, the esophagus is not properly formed. This results in two segments, one that connects to the throat and the other that connects to the stomach. However, the hollow centers of these two segments do not connect to each other, forming two separate parts. **__**When an infant feeds, the upper part fills up and liquid overflows into the trachea, causing severe respiratory problems. This overflow into the trachea is known as aspiration.**_

_**Then I mentioned something like OPCAB. Off-pump coronary artery bypass or "beating heart" surgery is a form of coronary artery bypass graft(CABG) surgery performed without cardiopulmonary bypass (heart-lung machine) as a treatment for coronary heart disease. **__**When a cardiac surgeon chooses to perform the CABG procedure off-pump, also known as OPCAB (Off-pump Coronary Artery Bypass), the heart is still beating while the graft attachments are made to bypass a blockage.**_

_**I am mean, I know I am. For let this hanging again. What do you think will happen? Will Cristina tell them what´s going on with Meredith? And if she is, how will they react? **__**I am really looking forward to write this chapter.**_


	10. Chapter 10

**Chapter 10**

* * *

**They say life doesn't give you second chances. But we do. Surgeons do. You break a bone, we put it back together. You bleed, we make it stop. You flatline, we resuscitate you. But as much as we give people second chances, surgeons don't usually get them, because the kind of mistakes we make, are sometimes impossible to recover from. It's hard to give second chances. It's even harder to ask for them. A chance to do it again, knowing what you know now, what you've learned. A chance to do it completely differently. A chance to right our wrongs, to try and correct our mistakes. A chance to try and start over, from scratch.** Meredith Grey; Could We Start Again, Please?

* * *

Dr. Webber sat behind his desk. Awkward silence filled the room ever since Dr. Yang and Dr. Bailey had entered the his Office. Cristina stared at wall, trying to avoid Dr. Bailey´s and Dr. Webber´s questions about Meredith. "Why aren´t you asking Meredith about that? It is not my place to say anything. Ever heard of doctor-patient confidentiality?" She snapped. "Yes, Dr. Yang, I have heard of doctor- patient confidentiality. I am a doctor. But I don´t think it is place to question us and our decisions." Dr. Bailey answered sharply. "I am gonna page Meredith." Cristina simply said and reached for her pager. Dr. Webber cleared his throat, but Cristina pretended like she did not hear the older surgeon.

"Yang. Look at me." Dr. Webber said, causing her to look up. "She won´t tell us and we know for sure something is wrong with her. So in order to help her we need to know what we are dealing with." He finished his speech. Dr. Bailey continued. "That something was wrong... I didn´t notice at first. She seemed like every other intern. Eager to get in on surgeries and then the whole ´She´s getting involved with an attending´- Thing happened. But then, one day, she turned cyanotic in my OR." Dr. Bailey said, recalling the pictures of Meredith in her OR.

Cristina nodded. Back then she didn´t know that her Person, the only best friend she´s ever had, has a complex combination of three heart defects. It came down on her as a giant shock. And she definitely wasn´t prepared for that then. Nobody knew. Only Derek, Mark, Meredith of course and her. About the others? Nobody knew. "You know what I am talking about, right, Cristina?" Dr. Bailey wanted to know.

"Yeah, I know." She answered. "So, tell me, Yang. What are the causes of cyanosis? Or to limit it a bit, let's say what are the causes of central cyanosis?" Dr. Webber leaned forward. This is a fucking trick question. "The causes of central cyanosis?" She repeated to win some time, before her world comes crashing down on her. "Central cyanosis can differ in cardiac cyanosis, which may indicate heart disease and pulmonary cyanosis, which may be a sign of a disturbed lung function and the associated oxygen deficiency in the blood." Cristina responded coldly. "And what can you say about the causes. Come on, Yang. I raised you better than this." Dr. Bailey commented.

_Why aren´t they asking Meredith about her medical history?_

_Why are they doing this to her?_

_Why are they putting me in this position?_

_It is so not freaking fair._

"Congenital heart defects. Cyanosis is the most substantial symptom which suggests congenital heart defects with right-to-left shunt in children, adolescents and young adults." She finally answered.

"What does this tell us considering the fact that Grey turned cyanotic in her OR while operating on a patient?" "You know what? This is getting ridiculous. Why aren´t you asking Meredith? And even if I told you what I know, it would not even be legal, so just freaking stop and ask her." She told them. "So you are telling us that you know what´s going on, but you won´t tell us?" Dr. Webber concluded.

"That´s what I am saying." He sighed. "Okay, when we said that you wouldn´t see the inside of a OR for the next time if you won´t tell us, we meant it." "Is that even legal?" Cristina asked. "I did not do anything wrong. The only ones who do something wrong are you two by cornering me to tell you about my person´s medical history." She stopped. "And let me tell you this. I am not, definitely not, going to jeopardize my very strong friendship with Meredith for some surgeries. I know that I don´t Sound like me, I know that, but sometimes friendship is worth to make sacrifices." Cristina told them with a strong voice. "Can I go know? ´Cause I will not tell you anything." She asked.

Dr. Webber did not answer this question. He stood up, and looked Yang right into the eyes. "No, Yang, I want you to tell me the damned truth. Right now. That´s an order." Dr. Webber commanded in an unambiguous tone. "I don´t care. I still won´t tell you anything." Cristina replied and shrugged. "Yang, tell us. Now is the time for you to tell me and Dr. Bailey what is going on with Meredith. We don´t do this, because we want to punish her for not saying anything; we do this because we care about her. _**So, tell me. Tell me. Now.**_" Cristina jumped, startled. But still, she did not talk. "Yang, we are waiting for you to fill us in on Grey's condition. It is obvious that there is something not like it should be." He spoke.

"No." She simply said and shifted uncomfortable. "Has she a heart condition or not? It's a simple question." "It may be a simple question to answer but it doesn´t change the fact that I am still not telling you." "Yang, you should tell us." Dr. Webber´s voice was sharp and he glared at her. "I am not going to tell you. End of story." Dr. Webber cleared his throat. He was definitely losing his patience with Yang.

"I am not authorized to say something about that." Cristina insisted. "So we've heard." Dr. Webber answered, slowly he lost his patience with Yang. "Talk to her about that. I am not going to tell you anything." Cristina stated. "It would be much easier for us all, if you just tell us straight out..." "What the hell do you want from me? I told you before that I cannot say anything." "I want you tell us the truth. Now, if it's possible." Dr. Webber nearly yelled. "Okay, you want to know the freaking truth?" Cristina exclaimed with strong emotions in her voice. "You really want to be responsible for destroying Meredith' trust in me and with that in our friendship? That's perfectly fine. But I want you to let her know that I did not have any choice, if she doesn't want to speak with me. Hell, I would not want to look myself in the eye right now. I am a horrible person."

Thirty- five minutes already passed. It felt like an eternity, like she had been in here for ages.

"You are not a horrible person. If you were a horrible person like you said you are, you wouldn't care. You would not give damn about how Meredith would feel what would happen in the aftermath." Dr. Bailey told her. "Now, will you tell us?" She asked, glancing at her frightened intern.

"It looks like I do not have a choice." She said slowly.

"You don't." Dr. Webber confirmed. Cristina pressed her lips together for a few seconds. Then she exhaled an inhaled slowly. Cristina wasn't sure whether it was the right thing to do or not. But she had no choice. "Yes. Meredith Grey has congenital heart disease." she finally answered, looking to the ground. Cristina did not have a choice. Either answering the chief´s questions or saying nothing and waiting for some miracle that will not happen.

Dr. Bailey and Dr. Webber exchanged glances that said more than thousands of words. They were right with their presumption about Meredith. "That is all I am going to tell you anything else you have to ask Meredith. I already told you too much. I don´t know if she´ll be able to forgive me for what I did." Cristina told them. Nobody said something. It was awfully quiet in Dr. Webber's office. They're shocked, even if they did not know the details of her condition. "Let's page Grey and get this sorted out." Dr. Webber murmured, as he reached for his pager.

* * *

**Meredith, six years**

_Ellis Grey was doing some important research to prepare for tomorrow's surgery. It was about seven o'clock, when she heard a soft knocking on the ajar door. Then a six year old Meredith came walking in, in her hand she held Anatomy Jane, a doll she got for her birthday years ago. It contained 24 parts/organs to take out, and extra parts to simulate pregnancy._

_"Meredith, I have no time for playing. I have an important surgery early next morning and I still haven't finished my research." She called out, without looking up. __Only the noise of the ballpoint pen could be heard. __But Meredith wanted to get her mother's attention. And she was very determined to get her mother's attention. __So she made noise. __Ellis wasn't very happy about that. "Meredith, please. A little less noise would be nice. I am working." She tried to get Meredith to listen, but her little girl could be very stubborn if she wanted to. And now that's the case. "Mummy, can I..." She started her sentence but was distracted by something. "Meredith, what do you want?" Ellis wanted to know._

_"I have a question." Meredith looked at her with big eyes. Sighing, Ellis put her pen aside and turned to her daughter. "Meredith. I am working. I already told you not to disturb me when I am working." Meredith ignored her mother´s words and stepped closer to the table. "What are you doing?" She asked with big blue eyes that were looking at Ellis. "Working, honey. I am working. I am preparing for a surgery I am going to perform tomorrow under my resident´s supervision." "So, you´ll be cutting someone open tomorrow. Is that what they did with me?" Ellis looked at her daughter in shock. She did not know How to respond to that._

_"Why is there this line? Is it because someone cut me open?" She asked, while pointing with her finger towards her chest. "Come here. Come here." Meredith followed her mother´s instruction and soon she was sitting on her mother´s lap. "Why is there a line, mommy?" __Ellis was taken aback when she heard the question her daughter asked, it was not what she expected. "You mean the small line right across your chest?" She wanted to make sure that her daughter meant that surgical scar on her chest. Meredith nodded and looked at her mother expectantly. "Why do I have something like this on my chest and the kids don't?" Meredith wanted some answers._

_"That line on your chest? It's a scar." Ellis told her, who was searching her mind for an explanation that a six year old could understand. "What is a scar?" Meredth asked with a sweet and totally innocent voice. When you were baby your heart was, well, it was different from those babies who were born healthy. So the heart doctor had fix it. In order to fix a heart, he opened your chest cavity. And it's so conspicuous, 'cause he had to go in three times." Ellis explained in easy word so that her six year old could understand what that meant for her. "Why three times? And how did they correct it?" Meredith asked. God, this girl really spends too much time around surgeons. Ellis shook her head. How is she going to explain this to her daughter?_

_"They´ve operated on you for three times, because they were focused on stabilising you so that you´ll survive, before the baby heart surgeon did the final procedure. Then there was a third surgery which has been performed due to a complication from the other surgeries. Though it hadn´t really been a complication, it was just that the tract prior your Aorta was too much and as a result there wasn´t enough blood flow. Maybe you remember bits and pieces from your surgery. It is only one year ago, but I hope that you don´t remember for your own good."_

_Meredith nodded thoughtfully._

_Then she asked: "Why didn't you do it? You're surgun too." Ellis chuckled. "It's surgeon, Mere. I didn't perform it because I am your mother and that means I am not authorized to go into that OR. Surgeons aren't legally allowed to operate on family members. You are my daughter and the law says that it´s forbidden to operate on relatives and family. You´re my Family, my child. Also, my specialty is general, means I work on bowels, livers and intestines." It was getting darker outside, but Meredith didn´t seem to notice._

_"Oh, right. What about the other kids in school? They talk." Meredith told her. Ellis sighed, she had really hoped that that wouldn´t be a Problem. But then there is PE. That means changing clothes for Sports and then back to normal street clothes. "Is it happening when you have PE?" Ellis asked. Meredith nodded. "They see the line and ask what happened and I don´t have an answer, but it´s not only that. They also talk behind my back. They stare and ´point and laugh at me, 'cause I am different from them." Meredith confessed shyly._

_"Whatever the other kids might say, you're survivor. You don't understand it yet, but you certainly are. And when you're older you'll understand why. So, it may be best if you try not listen to what they might say. They don´t understand things. Maybe they will when they grow older, but sometimes even adults don´t understand that kinds of things. Okay now, let's get you to bed." Ellis said and guided Meredith to bathroom. "Mommy, I don´t want to go to bed." Meredith was being stubborn. "It is late, Meredith. Other kids at your age are in bed at this time." She tried to explain. _

_"But I am no other Kids." Meredith replied. But then she yawned which caused Ellis to chuckle. Obviously, her daughter was tired but to stubborn to give in. Then they were in they bathroom. __"Clean your teeth and then I'll bring to bed, okay?" She told her daughter. Little Meredith nodded sleepily and without any complaints ... Now she was following her mother´s instructions without any complaints. _

* * *

Meredith Grey was in the OR, when she received the page. "Who's pager is it?" Dr. Montgomery asked without looking up, focusing on the neonate who was laying open on the table. "It is yours, Dr. Grey." The OR nurse said. "It says, report to the chief's office stat." The nurse read aloud and within second everybody´s eyes were on her. This was embarrassing for Meredith but she did not show it. She wasn´t weak, so she ignored all of them

Silence followed. Meredith Grey could feel the gazes of all present OR staff on her. God, this was embarrassing. She did not know she had done wrong, but then it got to her. Maybe they knew about her heart condition... god, hopefully not, she couldn't deal with that right now. But what else could it be about? It has to be about her damned heart. Meredith asked a nurse to take over for her, then grabbed her pager and left the OR.

_Why can't they stop looking at me like I have done something wrong._

_Creepy OR nurses. Chatty they are too, so that means..._

_Soon the whole floor will know about me getting reported to chief's office._

_Real problem..._

Meredith Grey knocked on the door to Dr. Richard Webber´s office, soon after that Dr. Bailey opened the door. She said with a unreadable face expression: "Come in. We have to talk." Dr. Webber looked at her with a somewhat shocked face expression. That is what she feared. They knew. Surely they knew about her so called thing. Her heart defect, the fact that she had been born with a complex heart defect. What should she do now? If they they already know, she can only try to do damage control. She sighed. Now they knew. At least it´s them. Not some nurses.

_Oh no, this wasn't good. I think they know about it. _

_But who told them? _

_That's what she didn't know. _

_Who could do something like that to her?_

But when she saw Cristina standing there, leaning against the wall, she instantly knew that it had been Cristina. That was a shock. She'd always trusted Cristina, how could she drive her so against the wall? What if she hadn't had a choice? But still, it hurts."Sit down. Do you have something to tell us?" Dr. Webber asked, eyeing Meredith, who did not know what to say.

When she didn't say anything, he continued: "Why didn't you say something and maybe a little earlier?" "Grey, what did you think keeping something like that a secret? You're a doctor, you know how dangerous it can be. Anyway, how about you tell us with what kind of heart defects we are dealing with?" "I thought you already knew, that Cristina had told you..." Meredith was surprised, positively surprised. "No, she didn't. We suspected that something would come up and Yang, she has only confirmed our presumptions. So don't be too hard on her."

Bailey sighed.

"You are the most frustrating intern I ever worked with and that now proves it. And don't you dare saying that is wrong, 'cause then you would be lying." Meredith was taken aback, she did not expect that. But seeing It in another way, it is to be expected. "So, why were you turning blue back then in my OR?"

"I was born with a congenital heart anomaly." Meredith answered, feeling slightly unsure. "Define cardiac anomaly, Grey. What heart anomaly were you born with and how did they treat it?" Dr. Webber wanted to know.

"It was..." She hesitated. "Take all the time you need." Dr. Webber encouraged her. "We are having this meeting 'cause we care about you, Meredith. You are not alone here. You have people that care about you." Meredith Grey smiled at him. "I didn't know what to say. You are supposed to be yelling, you should punish me for being such a fool." Here it is again, the self-blame.

"You are not a fool, Grey, you may have acted foolish but it doesn't make you one." Dr. Bailey cut in. "She is right. And here is another thing: you are like the daughter I never had." Cristina felt that his words made her feel a bit uneasy, so Cristina tossed her a supporting glance. Meredith nodded imperceptibly to show Cristina that she what she was trying to do, for being there for her. "l was born with complete Atrioventricular Canal Defect..." She began. "But that doesn't explain the cyanosis. AVSD is a primary acyanotic heart defect, it becomes cyanotic if..."

Dr. Bailey cut in. "She knows that. I am sure she does. Let the poor girl speak without interruptions." She scolded him. "Sorry, Dr. Grey, continue, please." He apologized and signaled for her to continue, to return to what's important. Meredith Grey swallowed. Now the hour of truth had come. "But that was not all." She told them, her gaze was directed into nowhere.

That they feared. "I was also born with an IAA associated with a 'Double Outlet Right Ventricle', short DORV. IAA means Interrupted Aortic Arch. That means I have a Taussig- Bing- Anomaly with AVCD or I was born with it." Now they know. Shocked silence filled the room. They know that 40000 children are born with heart defects in the US. They are the most common malformations a baby can be born with. But one of their own was born with it? That seemed not possible until the freaking universe proved them the opposite...

_Meredith Grey was born with an interrupted Aortic Arch?_

_That is a freaking joke._

_But it wasn't a joke. No, it was the truth._

_Her aorta had been interrupted ... that seemed unimaginable. _

_Her circulation had been dependent on her patent ductus arteriosus._

_If it had closed, she would have gone into cardiogenic shock. _

_All the time he did not know about it. _

_Ellis' little girl has a life-threatening heart anomaly._

"She never said anything." Dr. Webber said suddenly. That is the first time I hear that..." He repeated. Meredith knew he was talking about her mother. "I did my internship with her and she never said anything." He repeated stunned. Meredith didn't know what to say. Even Dr. Bailey was shocked and normally she didn't show emotions, but now...

"I think you should know that my right ventricle pumps the oxygenated blood through my system circulation." Meredith Grey interrupted the silence. They stared at her with open mouths. That was even more shocking.

"So they did a Atrial Switch Operation?" Dr. Bailey conjectured, she had taken over the conversation for now. Meredith just nodded. "They did. But I had open hear surgery three times." "Three times? But they correct a 'double chambered right ventricle' and interrupted aortic arch or other associated anomalies normally in one session, don't they?" She asked a bit confused.

"Yeah, they do, actually. When they did my first surgery, they were focused on reconnecting the interrupted ends of my aorta and since it has been hypoplastic, they did a Yasui- procedure to do a biventricular repair. Before closing me up, they did pulmonary artery banding and the surgeons took it down when they did the second surgery at the age of three months. When I was five, I've developed 'right ventricular outflow tract obstruction, that is the reason for the third surgery." Meredith answered Dr. Baileys questions who couldn't believe what her intern must have gone through. Sure, she had patients with this kind of abnormalities during her time as a resident, but it's not the same.

Surely it's not.

* * *

Meredith felt her chest tighten, suddenly it became more difficult for her breathe normally. She felt somewhat light-headed. The whole room seemed to be moving. Cristina looked at Meredith, who in fact didn't look well.

Meredith didn't paid attention to the other doctors in the room. She had enough to do with breathing.

_No. Not now. Make it stop._

_I need to breathe now._

_This damned heart, why can't it just..._

_Beat just beat..._

Cristina was focused on Meredith. Something was wrong with her. "I... I... can't..." She got out, trying to breathe. Her heartbeat slowed down, really slowed down. "Grey? Is everything okay?" Dr. Bailey noticed the struggle for air of the young doctor. Meredith tried to answer, but couldn´t get a word out of her mouth. Everything was blurry. "Damn it. Page Burke now, stat. We need him in here." She reacted fast.

Cristina could not believe that this was happening before her very eyes. Dr. Webber awakened and he tried to get her to take slow, deep breaths. Cristina hands tremble slightly when she took out her pager and paged Dr. Burke.

Hopefully he'll be here sooner rather than later.

If not for her, then for Meredith, who was close to lose consciousness at any moment.

* * *

**A/N: **_**How was this chapter? Liked it or not? Well, I am open for constructive criticism.**_

**_In a four-chambered heart, such as that in humans, there are two ventricles that operate in a double circulatory system: the right ventricle pumps blood into the pulmonary circulation to the lungs, and the left ventricle pumps blood into the systemic circulation through the Aorta. But in Meredith´ case the right ventricle does the work her left ventricle is supposed to do (Atrial Switch Operation because of Double Outlet Right Ventricle and associated abnormalities)._**

_**Cyanotic heart defects: Most cyanotic heart defects involve what is termed a right to left shunt. This means that blood from the right side of the heart, either the right atrium or right ventricle, bypasses the lungs and travels directly back out to the body. This usually involves a hole in either the atrial or ventricular septum, as well as some type of obstruction to blood entering the lungs. Relatively common cyanotic heart defects that are classified as right to left shunts include tetralogy of Fallot, tricuspid atresia, pulmonary atresia, and severe forms of Ebstein's anomaly of the tricuspid valve. Other cyanotic heart defects may be classified as parallel circulations. The most common heart problem in this group is transposition of the great arteries. In this situation, blood never appropriately mixes but instead travels in parallel circuits, one to the body and one the lungs.**_

**_Cyanosis is a physical sign causing bluish discoloration of the skin and mucous membranes. Cyanosis is caused by a lack of oxygen in the blood. Cyanosis is associated with cold temperatures, heart failure, lung diseases, and smothering. It is seen in infants at birth as a result of heart defects, respiratory distress syndrome, or lung and breathing Problems._**


	11. Chapter 11

**Chapter 11**

* * *

**When you become an intern, there's a ceremony where you get your white coat. Like magic, you're a doctor. My parents came to my white coat ceremony. I can still picture them. So happy, so proud. They say your life flashes before your eyes right before you die. The important moments. The moments that tested you. The moments that made you who you are. I don't know about my life flashing before me. I was thinking about my white coat and how I'm glad I have it on me right now. It's the moment my life started. Seems fitting it should be on me when it ends. A doctor puts on his white coat to save lives, defy death. But once he takes it off, he's vulnerable, just like anybody else. Human. We're all gonna die. We don't get much say over how or when, but we do decide how we're gonna live. So do it, decide. Is this the life you wanna live? Is this the person you wanna love? Is this the best you can be? Can you be stronger? Kinder? More compassionate? Decide. Breathe in, breathe out, and decide.** Richard Webber; Seal Our Fate

* * *

When Dr. Burke got the page from Cristina, he was checking on his post-ops. Mrs Peterson was two weeks post- op from a quadruple bypass surgery and ever since recovering very well. Also, the procedure went textbook. "Mrs Peterson. Your vitals are great, so is your incision. It is healing properly. I guess we can discharge you sometime in the next few days." he told her and remarked that in her patient file. "Oh that is great. Thank you Dr. Burke. So much. I am so so happy to Finally get out of here. God, I have to call my husband. He will be happy to hear about it." She smiled while searching for her cell phone in her bag. "I have to go." Dr. Burke said, when his pager beeped. He read Cristina's message. She sent him: _\\\Emergency, come to chiefs office now, high urgent\\\_ and instantly knew it was really important, if not even a 991. And why is he paged to the chief's office? Anyway, he knew something bad was going on. So he started running to chief's office. When he reached his location his pager shrieked a second time.

Meredith slowly lost consciousness. Her condition took a turn for the worst. First, everything was blurred. Vaguely she could make out the panicked voices of Cristina, Dr. Bailey and Dr. Webber. She tried to fight against the black that had suddenly overcome her, she really tried to stay awake, but she didn't stand a chance. Then, blackness surrounded her. Meredith heard someone call her name, but she couldn´t respond in any way. Everything blurred before her eyes, she could barely breathe normally. It took her an enormous strength. Then she was pulled into the dark. She didn't see the other surgeons in the room start freaking out. Dr. Webber and Cristina were both frozen due to emotional shock, they were emotional too involved. They could not fully comprehend what happened before their very eyes, it seemed unimaginable. Still, it had happened- no one could deny that ...

Dr. Bailey was feeling for Meredith' pulse. It was irregular and faint, but still, it was there. Also, it was thready. "Her heart rate is bottoming out. Her condition is deteriorating fast. Where the heck is Burke?" She called out, her voice raised, although she knew she was supposed to be calm. "Page him again." She commanded toward Cristina who looked at Meredith' unconscious form.

"Yang. Did you hear what I just said? Now do it." Bailey ordered.

Cristina awakened from her frozen state and paged him again just as he came through the door. They paged him again. When he pushed open the door, he immediately knew what was wrong and why he was paged. On the ground lay a small figure in light- blue scrubs, he immediately recognized her as Meredith, his girlfriend's person. "What happened?" He asked, already fearing the answer.

Miranda Bailey was kneeling next to her, feeling for pulse. "Thank God you are here." Dr. Bailey exclaimed, a worried expression all over her face. He looked to Cristina, whose face looked a bit tear- stained and anxious. She's concerned about Meredith, he guessed. What's causing her lose consciousness and barely having a pulse. Most likely it's her heart, since she's had problems with it since birth. "Help her." She whispered worriedly with a shaky voice.

"I need you get me up on speed on her condition. Has she got any risk factors or a family history with heart problems?" He said, while pulling out a stethoscope, shortly assessed Meredith's current condition and at the same he gave Cristina a calming gaze, before he turned his attention back to the person laying unconscious on the ground. Cristina's lip quivered as she watched Dr. Preston Burke examining Meredith Grey, her person. This wasn´t real, she needed it not to be real. Unfortunately, it was real. Really, friggin' real.

He started listening to her heart sounds and then he moved on to her breath sounds. Dr. Bailey answered him, hectic and panic in her voice: "She's..." Dr. Burke already applied a transcutaneous pacing pad to chest in case they have shock her to save her life. Then he noticed the thin but clearly visible line on her chest. It was a surgical scar, that was clear. She has had open heart surgery before. She is a heart patient. He was a cardiac surgeon and knew how a scar like that looks like.

"Damn. She's had open heart surgery more than just once. We need to get her on a portable monitor, pulse ox and cardiac echo. We need move her to CCU for constant monitoring until we know what is going on. Move." Dr. Burke ordered when he saw the line right across Meredith' chest. "Get a gurney in here now." He then shouted, practically. But then the monitor she was connected to showed signs of second degree heart block. Immediately a shrill, in increasing intervals coming sound appeared.

_Damn. __This wasn't good. _

_That was far away from good._

On the monitor regular P waves were visible that are not reconciled to the chambers. The atrial and ventricular actions run completely independent of each other. It formed no ventricular escape rhythm and therefore cardiac arrest.

"0, 02 mg / kg atropine intravenously. Now." Dr. Burke commanded. He began cardiopulmonary resuscitation, Dr. Webber injected the medication and his gaze was stuck on the monitor screen. No changes in the ventricular complexes. "Unsuccessful, then give her intravenously 0.01 mg / kg orciprenaline." He ordered. Cristina was watching everything.

_No. __This could not be happening. _

_This was supposed to be a normal work day._

_**In the CICU**_

Cristina looked at her friend's face. Right now, she looked vulnerable, laying there motionless, the transcutaneous pacing pad applied to her chest in case she codes again. She had not regained consciousness since she had gone into bradycardic arrhythmia. Most likely it had been a Mobitz type II Second-Degree Atrioventricular Block.

It can occur in patients with Atrioventricular Septal defect. It's a known complication. Mobitz type II Second-Degree Atrioventricular Block. That meant pacemaker indication. Patients with this, even those who have been asymptomatic, are at risk for developing Third-Degree AV block also known as total heart block, which means cardiac arrest if there's no ventricular escape rhythm.

She heard the frequent sounds the monitor made every time an electrical impulse occurs on the screen. It was surprisingly comforting. She hoped Meredith would regain consciousness soon.

"Come on Meredith. Don't let me down on this one. Open your eyes I know you can do it." She tried.

Derek doesn't know yet. He in the OR operating on someone's brain. Dr. Burke wanted to do an EP study. Cristina had signed consent. Now she had to decide about her person's medical treatment. Meredith was not able to do that now in her current state.

"How is she?" Dr. Burke asked. "Still unconscious." Cristina answered. "And hypotensive. When do you want to do the EP study?" she questioned. "Soon. I'll try to schedule it today, but we might want to wait for Shepherd." He replied. "I just talked with Dr. Bailey about Grey. She said that Grey had been born with Taussig-Bing-Anomaly. How come nobody of us knew anything about that? Why the hell did she ´keep this a secret. It could have cost her her life." "She told me and Shepherd after he noticed the scar on her chest." Cristina confirmed this.

"I really should've taken the signs seriously. We all should have, but we didn't know. I know it's a lame excuse, it's just..." The cardio-thoracic surgeon didn´t finsish his sentence. Silence, only the regular sounds of the heart Monitor could be heard.

"That we could have prevented this? Yeah, I wish we could have." Cristina said. "Burke, will she need a pacemaker? Chances are she might need one, right?"

_She doesn't need one. _

_It can't be._

_But... it is also possible that Meredith may need one._

"We have to wait until we know the results of the electrophysiological study, before we decide about the course of treatment. Actually, I am here to do the cardiac echo and the 12- Canal ECG." He explained, while checking her heart monitor. At this moment, it was an almost normal sinus rhythm. He was glad about that. But they really needed to know what was going on. I'll leave you alone with her. Page me if anything happens."

Cristina just nodded and softly stroked Meredith' hair, hoping she would wake up soon. Why does this keep happening? Why can't they just be happy and live their freaking life like other people do? She didn't understand why it cannot be easy for once. She already lost her father in a devastating car crash when she was young and now, what if she loses Meredith?

No, she won´t. Dying is not an option for her. Cristina was looking at Meredith` ECG curve. Constant and regularly beats were registered on the screen. Suddenly she felt a slight movement coming from her person. Cristina could not believe it. She was waking up. Finally, she really took her time. "Meredith?" She heard herself asking aloud, hoping her person would make any attempts to answer even if not understandable. She felt relieved that her person was waking up.

"Meredith?" Cristina asked again, loud and clear.

There was no answer coming from Meredith at first, but then she moved and suddenly opened her eyes. "Meredith? You hear me?" She questioned repeatedly.

"Cris... Is tha... that you?" Her voice hoarse.

"Yes." She answered relieved. "I am here. Don´t ever do a stunt like that Again. Ever, or I will kill you and bring you back to life." Cristina warned her person. Meredith blinked, as if she could hear and understand what Cristina said to her. And she did understand.

Meredith somehow recognized Cristina´s voice. Everything was a blur, like she´s been unconscious for a long time. Then she noticed that there was oxygen mask strapped over her nose and mouth and then the faint beeping of the cardiac monitor.

_I am in the CICU. _

_Again. Why Again?_

_But then, why am I here, was I having arrhythmias and was admitted because of that..._

Meredith tried to remove the oxygen mask, but stopped Meredith' hand that trying to get off this plastic thing. But she needed it to keep O2 saturation level. At least that is what Cristina told her. And she believed Cristina. However, she was to tired to care about whether she should take the extra oxygen or not. With effort she turned her head so she could look into Crístina´s eyes.

"What happened?" She asked, because she really wanted to know why she was laying in a ICU bed connected to all kinds of medical devices and why she has a pacing pad applied to chest, which could mean that she coded or almost coded. So, we are back to the arrhythmias. Cristina hesitated noticeable. She didn´t want to agitate Meredith, ´cause maybe that would cause trouble during the time in the cath lab, when the EP study. And she didn´t want to worry unnecessarily.

"Come on, Cristina. I won´t break down. I´ve had lots of those moments, where some doctors tell me some serious diagnosis, so just tell me... I can take it. Is it my AV block, I was diagnosed with second Degree type one when I was a young girl."

Cristina inhaled sharply.

* * *

**Flashback: Meredith, four years**

_Meredith coughed. She was laying in bed with a deep cough and high fever since Thursday. She´s been sick for a few days and it didn´t get any better. It just intensified, so Ellis Grey was getting worried. As a doctor she knew children with congenital heart defects were more susceptible for respiratory diseases. It seemed like Meredith had catched one of those. _

_So she had to stay home for some days waiting for it to get better, but that didn´t happen._

_"Mommy. I don´t feel good." Meredith complained with a hoarse voice, Ellis immediately noticed Meredith´ pale complexion and the heavy breathing with wheezing sounds. She seemed drowsy. She was standing in the kitchen wearing a pyjama and was searching for mother. A High-pitched breathing sound could be heard, when she was exhaling and sometimes even when she was inhaling. _

_Again, Meredith coughed and couldn't stop. Maybe something was blocking her airway. "Just breathe." Ellis tried to soothe her. Finally her coughing fit stopped and she could get air to her lungs. __"Let's get you back ln bed, before you make it worse as it already is." Ellis said and lifted her up. __Meredith whimpered and leaned her head against Ellis ' neck. __She closed her eyes and was half asleep when Ellis reached Meredith' room. But then she had another coughing fit. _

_She was coughing up thick purulent coughing secretions, that filled her trachea. _

_Meredith was semi-conscious, while trying to breathe. No, this had to be something more serious. It wasn´t just some sort of a weird clinical presentation of a cold or Bronchitis, this was something much more serious. She should take her to an ER. When they arrived, they had to wait for a doctor to come, ´cause there were seemingly 'more severe' cases than Meredith' case. You know, it's the thing called 'triage'..._

_But they were wrong. After twenty-five minutes of waiting, Ellis was angry. How could they let her little girl suffer like that? It was unbelievable. Meredith' eyes were half open as she tried to recognize where she was. Her breathing had gotten worse over time. Suddenly Ellis noticed that the muscles between the ribs pulled in as her child tries to breathe. Meredith had another coughing fit. __"Just breathe. The doctor will be here soon." "My chest hurts." She complained, her cheeks flushed red, signaled she developed high fever._

_This wasn't a good sign, if she said that she had retrosternal pain._

_Maybe it was pneumonia or acute bacterial tracheitis or pleurisy. Most likely it is tracheitis. At least the symptoms fit. Ellis was slowly losing her patience. She worked night shifts at the hospital. She knew how the system worked, some patients died when forgotten from doctors or residents who don't know the ass from the esophagus, were roaming the halls of the hospital sleepwalking. But she wouldn't let that happen to her daughter._

_"We need a doctor to examine my daughter. She has difficulty breathing. Now, get me a doctor, an attending. And should happen before she goes into respiratory arrest." She demanded. The nurse looked up, she was typing something on the computer, yawning. Ellis looked at her in shock. How could this be possibly true? "Now." Ellis was infuriated. "I'll see what i can do. We're extremely backed up right now." _

* * *

Derek was standing near the Nurses Station / OR Rotation and he was looking at the OR rotation. He was doing a craniotomy this afternoon. Burke was scheduled for an emergency electrophysiological study on some VIP patient. He wanted to find Meredith, to look how she is doing. He was hovering, and she hated that but he couldn´t help but worry about her. Maybe he should try and let her be on his Service so that he could be sure that she is okay. But then, he said to himself, that she was a doctor too and knew when somethings is wrong. He paced up and down the hallway, somehow he had a feeling. A bad one. Then he heard Dr. Bailey´s voice behind and him and he turned around.

"I have to talk to you." She said, desperately trying to show no emotion. But before she could go further on, Addison Montgomery appeared out of nowhere. "Dr. Bailey, where the hell is Grey? I´ve been paging her forever. Are all of your interns sloppy? Even Karev is more reliable." She complained.

Dr. Bailey looked at the red-haired woman. It was unbelievable. What the hell is this woman thinking? "Don´t you dare say that, Montgomery or I´ll tell the Chief and let me tell you he is in no freaking mood to deal with one of his attendings making stupid comments about his staff. Grey would have answered her pages if she could but right now she isn´t officially working." "Miranda, what´s wrong?" Addison was taken aback, she had thought Grey just didn´t want to answer her repeated calls and pages. Apparently she had been wrong. Very, very wrong. "I am sorry. I did not mean to offend you." She stuttered, obviously she was nervous and unsure of what to say to her subordinate.

"Something happened and Grey just isn´t available. You may take Karev. Do not even think about asking." She advised. Addison looked frightened. Funny that even the attendings had fear of Dr. Miranda Bailey and her speeches. "But Karev is my intern." Derek said protesting, not understanding why Addison should take his intern for the day. He has some elective procedures scheduled for today and Alex was going to assist.

"Believe me, Shepherd, you won´t be able to do any surgeries today." Bailey said. "Now come with me." She ordered. "I´ll just page Karev." Addison called after them as they were disappearing down the floor. Dr. Bailey walked fast, and he had trouble keeping up with her, 'cause it was so unexpected. Now Derek was alarmed. He suggested that Dr. Bailey´s weird behavior had something to do with Meredith.

"Where are we going?" He asked worriedly.

Dr. Bailey just replied one single, word. But that word shattered everything: "CICU." He was right. Meredith, something has happened to his Meredith. Why? CICU meant Cardiac Intensive Care Unit. That could only mean... This was about Meredith, indeed. But what happened and how did she find out? There were so many unanswered questions. But the most important thing was that she is okay or at least going to be okay. "What happened?" He asked, his voice near hysterical. Dr. Bailey didn´t answer, she just walked. "Dr. Bailey. What is going on? It is about Meredith, I mean Dr. Grey, right?" He wanted to know, his voice shaking.

* * *

**Flashback: Meredith Grey, four years**

_"I don't care. Do something now. Page the on call attending right now. I know how the system works. I am a surgeon, so do something more helpful to prevent the closing of my daughter´s airway right now."_

_"I´ll see what I can do, but there are more..."_

_"Let me tell you something. We have a pediatric patient with high temperature, troubled breathing associated with wheezing sounds and retrosternal pain and on top of that she is a pediatric heart patient. Get me a freaking doctor before she goes into respiratory arrest, which is going to be the case if you don´t secure her airway." Ellis couldn´t hear anymore excuses. _

_Meredith moaned slightly, her eyes glassy and half-closed. Her breathing was more labored than before, suddenly Meredith started turning blue because of the lack of oxygen. She wasn't breathing anymore. Respiratory arrest. Meredith' body went limp in Ellis' arms. Immediately Ellis reacted. She hit the code button with full force. This damn hospital. _

_A computer voice said: "Code Blue, Emergency Room. I repeat, code blue."_

_"It wont pass. her throat is too swollen." The ER doctor on call said as he tried to tube her. "__Get the fibre-optic scope. Now." He ordered with a loud, demanding voice, while Meredith´ heart Monitor went crazy. Her heart rate is slowing down rapidly, even her pulse ox is falling. __"We've got to ventilate her. Heart rate is slowing. Sats are bottoming out." Damn, her airway is obstucted, he cannot get the tube to pass. Ellis watched the Scenario. She couldn´t believe that this was happening. Why haven´t These morons reacted earlier when it wasn´t that bad?_

_"Where is the damn scope?" The doctor shouted hysterically, Meredith´ pulse fell rapidly and there was nothing they could do about that, if they did not get that damn endotracheal tube in to help her breathe, which obviously she couldn´t do on her own._

_"It's coming." A nurse, looking at her heart monitor, said. "Do something." Ellis told them with a shaking voice, trying to hold herself together. "We´re trying, but we..." "Move." Ellis cut him off, grabbed a pair of sterile gloves and reached for the smallest endotracheal tube she could find. The doctor stared at her, his mouth wide open as he continued to stare. That incompetent idiot did not even know how to intubate a child. Stupid morons here._

_Wait, what did that woman think she was doing? She didn´t even know how to intubate a patient. She was a civilian. She could not tube her own daughter._

_"Wait. Stop right there. The scope is coming any moment." He tried to stop her, but without success. Meredith´ oxygen saturation went down. Now it was only 70%, they had to intubate her or this girl's gonna be dead. Ellis tried get the ET tube in, but her trachea was filling with copious tracheal secretions and blocked her airway. "Damn it. O__pen up a surgical tray. i am gonna crike her. Hold this."_

_"Wait, stop. What are to doing? You aren´t a doctor. You'll kill her if you..."_

_"I am a surgeon, moron. Now. Betadine and scalpel." She ordered, but the man didn´t move. "Just wait. J__ust wait. It is coming." She did not react to that. __"Her heart rate is down to 40. i am doing this. Betadine." The nurse was about to do what she said, when she saw a man running towards their Trauma room, causing them to glance up and see his Hand Holding the fibre-optic scope. "__Wait. wait, the scope is coming." The nurse warned Ellis._

_"Slowly. easy does it." Ellis reminded herself as she took the scope and introduced the tubus slowly and carefully, in order to minimize trauma to the inflamed subglottic area. __"Almost there, almost there." She murmured to herself, then: "I__ got it. Endotracheal tube is in. Sats are going up. And up and it´s almost back in the normal range." Relief spreaded through her as she saw that her heart rate is going up and her oxygen levels too. When she was sure her daughter is stable, she looked at the frightened doctor._

_"You... " She began. "You easily could´ve killed her. What kind of doctor are you? What is more important than a four year old kid with troubled breathing who is near respiratory arrest? I don´t know what you were thinking. Get your superior and page peds, tell them we have a four year old girl with suspected acute bacterial Tracheitis." The intern nodded intimidated, when he left and sent an alert to pediatrics._

_Ellis sighed and looked at her little girl, who was connected to a mechanical ventilator. That what happened here also could have turned out completely differently. This disease progressed rapidly and fulminant._

* * *

The General surgeon stopped in her track and faced the angry neurosurgeon, who looked like he was going to freak out at any minute. So she said, did not wanting the one to tell him what happened to Meredith and why she is lying in Cardiac Intensive Care Unit and waiting for a cath lab to clear up to get her electrophysiological study done, sighing: "Did you know she was... has a history of cardiac problems?" The general surgeon looked for any evidence that would show her that he knew about Meredith Grey's heart defect. That´s what he feared. It is her heart causing the problems. He should´ve taken her to the ER when she collapsed in his arms.

Slowly he nodded. "I do know. She told me." He answered, his thoughts racing.

For a few seconds she just stared at him, as if she could not believe that he was saying what he was saying. _He knew, just as Cristina he knew before her and the Chief of Surgery. _"Just tell me. I can take it." Derek demanded and tensed instinctively.

"Oh, can you?" She asked him bluntly. Derek was shocked. This was not funny. "Bailey. Right now is not the right time for sarcasm." He said, his voice hoarse and filled with worry. "I am sorry, Derek. I did not mean to be that insensitive." She apologized to the neurosurgeon. That Dr. Bailey noticed and the worried expression on his face. She would be too, if she were in his Position, especially in his Position. She, of course, was worried too. Grey was one of her interns, one of her babies and she cared about her babies. "Meredith is collapsed while we were trying to find out what is wrong with her. We paged Burke to assess her condition. We think that she may have have a Mobitz type II Second-Degree Atrioventricular Block. Which means she..."

"... She may need a pacemaker." Derek cut her off, his voice toneless, unattached like he tried to think of her like any other patient in this hospital. "Which room number?" Derek wanted to know. Dr. Bailey ignored his question and continued: "We'd like to do a electrophysiological study and some other diagnostic tests to confirm our suspected diagnosis. Anyway, it's Cristina's decision to make, she is Grey's medical proxy."

"Is she awake and responsive?" He asked, there was concern in his voice. Dr. Bailey: "Last time I checked, no she wasn't conscious. Maybe she's now. It's been awhile." The general surgeon told him. Derek pressed his lips together and tried to process everything. "I should have..." "You." Dr. Bailey stopped him almost immediately. "You stop right there. You are not to blame, maybe we could have prevented this from happening mabe not. It is all written in the stars, we don't know what we could have prevented and maybe it would've happened anyway, so, that's what you do..."

She stopped when she got a page from Cristina.

She scanned it, then she turned her attention back to Shepherd.

"... we visit her room, my pager to told me that she woke up. Yang paged me." She told him. "She is awake." Derek repeated. "That´s good." Dr. Bailey nodded approvingly. "It is." She confirmed. "Let´s go." She said. "We´re going to visit her." She then was on her way to Cardiac Intensive Care Unit. When she noticed, Derek´s hesitation, she motioned him to follow her.

* * *

**_A/N: That chapter was not very easy to write, it involved a lot of research because of the arrhythmias and rhythmology and arrhythmology. _**

**_Rhythmology is not easy to understand with all its P waves and QRS- Complexes and then there are all kinds of arrhythmias. Bradyarrhythmias are heart rhythm abnormalities that cause an abnormally slow heartbeat. Tachyarrhythmias are heart rhythm abnormalities that cause an abnormally fast heartbeat. And so is arrhythmology.  
_**

_**Heart block is a term for a delay or interruption in the heart's conduction system, causing the electrical impulses to travel too slowly or to be stopped. There are several kinds of heart block, classified according to location (where in the conduction system the block occurs) and degree (whether the block is mild, causing delayed conduction, or severe, causing conduction to stop). In first-degree atrioventricular (AV) block, all electrical impulses reach the ventricles from the atria, but are abnormally slowed as they pass through the AV node. In second-degree AV block, some atrial impulses fail to reach the ventricles ("dropped beats"), resulting in a slow or an irregular heart rate. In third-degree AV block, the most serious form, no atrial impulses are conducted to the ventricles. This condition is sometimes called complete heart block. For the heart to continue to beat, a separate electrical impulse (called an escape rhythm) may be generated in the ventricles. Without an escape rhythm, the ventricles stop beating.**_

_**So, Meredith has Mobitz type II 2nd-degree AV block. Mobitz type II 2nd-degree AV block is always pathologic; the block occurs at the His bundle in 20% of patients and in the bundle branches in the rest. Patients may be asymptomatic or experience light-headedness, presyncope, and syncope, depending on the ratio of conducted to blocked beats. Patients are at risk of developing symptomatic high-grade or complete AV block, in which the escape rhythm is likely to be ventricular and thus too slow and unreliable to maintain systemic perfusion; therefore, a pacemaker is indicated.**_

_**Now, what's Tracheitis? It's a good question. It´s in an infection of the trachea. The signs and symptoms of bacterial tracheitis are frequently intermediate between those of viral croup and epiglottitis. After an antecedent upper respiratory tract infection of 2–3 days, the child becomes rapidly (8–10 h) and seriously ill with a high fever and respiratory distress. Coughing produces copious tracheal secretions and retrosternal larynx, trachea, and bronchi can become acutely obstructed with purulent debris and inflammation with adherent pseudomembranes overlying friable tracheal mucos****a. ****Most patients with bacterial tracheitis will require tracheal Intubation.**_


	12. Chapter 12

**Chapter 12**

* * *

**Patients say it all the time: 'Tell me straight up. I just want to know what's going on. Tell me, I can handle it.' We don't dodge your questions because we're mean. We do it because when you say you want the truth, you have no idea what you're talking about. They say the truth will set you free. What the hell do they know? The truth is horrible. Frightening. The truth is more than you can bear. We're supposed to be straight with you, so be careful what you ask for when you walk into a hospital. Because when you find out what's really going on, you may never recover. **Meredith Grey; She´s Killing Me

* * *

Cristina stared at her friend without even the slightest movement. _Wait, she did know that she has bradyarrythmias... This has to be a freaking joke. Why did not she tell anyone?_ Meredith looked down, she knew what her person was thinking right now. _Why didn´t I tell_ her. She cursed herself. _Well, now I did tell her. But it was a little to late._ Before she could say anything, Cristina stood up and left the room without a word. Looks like the situation finally takes its toll on her. Meredith just watched her go and didn't stop her.

She's Cristina, she'll always come back.

She may need her time, but she'll be back at some point.

Meredith breathed in deeply and tried to ignore the nagging feeling that now everything is open on the table, that she now plays with open cards. Soon Izzie, Alex and George will know. With them the questions and maybe even anger, 'cause she did not tell them. They'll hear it from those chatty nurses, Meredith was sure, this would spread like a virus.

She leaned back, closed her eyes and tried to forget that she was in the Cardiac Intensive Care Unit and is about to be examined in a cath lab and maybe even go under for a real surgery, which will be most likely the case considering her aortic valve is narrowed and may need to be replaced and as icing on the cake she may even need a pacemaker.

_A freaking pacemaker... _

_A little device implanted into your chest to remind the heart that it has to beat regularly..._

_Damn heart defect. Why me?_

_Wh... whyyyy... me..._

She was aware of the fact that there are children who need a pacemaker or an ICD because they have arrhythmias, but it didn´t change anything about the very likely possibility that she might need one. Meredith shook her head. Pacemaker.

_Why does it always have be her? Did she have had some mysterious sign on her body that said: Please let all the crappy things happen to me... I am a lighting rod for them._

Okay, that was kinda exaggerated but it felt like it was true.

It seemed so far away. The point where she needs a pacemaker. It seemed so far away and now... It was there. The point where she needed a little device implanted in her chest to remember her heart that it has to beat regularly. Meredith knew that this might be coming on the long row, but now... right now it seemed unbelievable. Incomprehensible. Suddenly a dark figure was standing in the door, leaning against it and looked at her with his blue, dreamy McDreamy eyes. It was Derek. Miracle, who else could it have been with those McDreamy eyes looking right at here.

"So I heard something. Rumours. Or more, it was Bailey who told me that you decided to code." Derek said, coming towards her, immediately noticing the transcutaneous pacing pad on her chest. "It's not like I planned to do this." Meredith replied, a slight hint of a fake smile covered her face. "Of course you didn't plan it. I was just..." Joking..." Meredith cut him off bluntly. Derek looked at her, she looked now kind of fragile and even thinner than usual. "Come here." She made place for Derek, which wasn't so easy with all the wires and electrodes, but she made place for him, so that he can lay with her. She motioned him to join her. "You want me to..." He asked, understanding what she wanted. Meredith nodded.

"If Bailey catches us, I am dead." He warned. "She won't kill you." Meredith told him, almost laughing. "She will after giving me the famous 'Bailey- speech'." Derek mumbled in her hair as he embraced her with his arms. "Okay, you´re right. She'll probably kill you." "Thanks." For awhile nobody said anything, they laid there, Meredith half on Derek, who seemed to enjoy this Moment with Meredith even if they were surrounded by Hospital devices and beeping sounds in an ICU room. Meredith felt the warmth coming from Derek and relaxed. She breathed in his scent.

But this nice, little moment has its sudden end when Dr. Miranda Bailey comes through the door, in her hands some paper, presumably her lab reports. She Begins talking as soon as she steps in the room: "Grey, nice to see you awake. I suppose Dr. Shep..." Abruptly she stopped when she saw Derek laying next to the intern and embracing her.

"Please tell me..." She slowly said. "...that it's not what I think it is."

Derek looked at Meredith' resident with a shocked and terrified expression and didn´t move a millimetre. He swallowed and braced himself for what was about to come. Meredith also looked at her resident in horror. That is kind of deja vu, like the situation with the party and the interrupted car sex. Just without the sex. But still, it was kind of embarrassing for her and for Derek.

_Oh, God. Please tell me this is a freaking imagination. _

_My mind is playing tricks. _

_Bailey catched us in a bed in Cardiac ICU. _

_Together. We. Are. Laying in one bed. In. Cardiac Intensve Care Unit._

_God, that is embarrassing. Very embarrassing...  
_

She stared at them unbelievably as if she tried to figure out if this was real or just some sort of crazy imagination coming from her overworked, sleep deprived mind. She tried to figure out whether she should do something or yeah, she would give them the ultimative Bailey speech.

"I really hope for you two that my very sleep deprived brain is playing tricks or it will be very uncomfortable for the both of you. What are you doing? That is an ICU room. A Cardiac ICU room for patients who need to be monitored constantly because they`ve had surgery recently or are unstable and are about to go into surgery or other explorative procedures like an EP study, like you, Grey. Same goes for Mr McDreamy with the super hair." Miranda Bailey ranted.

She pointed with her finger at Derek, who wanted to disappear now.

"See, told ya she would kill me." He whispered into Meredith' ear.

"She'll kill us both for being that foolish." Meredith gave back quietly, trying to ignore Bailey's ranting. But Bailey`s ranting speech was very difficult to ignore so she just listened to hear. Anyway, it wasn´t like she had a choice not to have to hear it. "She is admitted to Cardiac ICU because of bradyarrhythmias. She needs to be monitored 24/7 and you thought it would be a good idea to do that? For a brain surgeon you can be so damned brainless, so that's clear. Where is your rational thinking?" Bailey scolded him.

_It´s flown away,_ he thought to himself. _My sense for rational thinking is flown away someplace else... Okay, maybe I should stop thinking idiotic things like that._

Derek did not know what to answer. So he stayed silent. It was for the better to just stay silent for the sake of both of them. Dr. Bailey waited for any reactions, but there were none. "So that means for you, Shepherd..."

"Now it is Shepherd, back then it was McDreamy." He said smirking. Dr. Bailey huffed at his comment and Meredith couldn´t help but laugh at Bailey´s face and her reaction. "Nice that you think that it´s funny, Grey. Do I have to remind you that you´re the one laying in a Hospital bed, correction, ICU bed and about to undergo a cardiac procedure." "No, you don´t have to remind me. I am perfectly capable of doing this myself. But anyway, what about the other physical exams like an cardiac echo... It´s what you do when you know the patient has heart problems."

Derek tried to hold back a laughter.

Meredith was telling Bailey what she should do. Now that funny and hilarious. And even a little out of mind. "I am gonna ignore your stupid little comment, Grey. If you weren´t a patient I would have made your life a living hell." "I know that, Bailey, but being a patient is boring and some fun would be nice to distract me from the fact that I may be getting a pacemaker."

* * *

"I need to cut." Cristina Yang appeared out of nowhere on Dr. Burke´s side, who staring at the OR board. His next procedure was Grey´s EP study, where he wouldn´t let Cristina scrub in. She isn´t even in that OR not if he´s operating on Meredith Grey, who is like Cristina´s sister and you don´t let family members operate on family. Preston looked at her with raised eyebrows. Expectantly he waited for her to continue.

"I need to cut. I need to cut. I need a surgery, damn it." She repeated over and over.

That is Cristina-like coping.

"Please let me scrub in on some surgery. I need it. Really." The korean doctor pleaded, scanning on the same time the OR board for interesting surgeries. She is trolling for surgeries aka coping. "I can´t let you scrub in, Cristina. Even if I wanted to let you in on her case, I couldn´t ... You aren´t legally entitled in this OR." "It is not an OR. Simply as it is, it is a freaking cath lab. A cath lab. I´ll be just watching. Please let me in, I need to feel like myself again, I need something to cut into." Cristina leaned herself against the nurses Station, covered her face with her bare Hands. Dr. Burke watched the korean doctor and thought about whether he should let her scrub in.

"How is she, anyway?" He asked. "Awake and responsive. Did you know that she knew about the arrhythmias?" "What do you mean with that?" Preston asked alarmed.

"Nothing. Just forget it." Cristina waved him off absently. "What about the surgery?" Before Dr. Burke could begin to answer, his pager beeped. He looked at it. "It´s Bailey, she is paging me for a consult."

"She is paging you for Mer, right? I'll come with you, anyway, it is just an EP study. No big deal." Cristina told him and followed him to Meredith' ICU room. "It is a big deal, because she´s is your friend." "She´s my person." Cristina gave back. They reached Meredith's CICU room. Shepherd was there too and he looked like he had done something wrong. Meredith seemed quite amused by what she saw, though it is partly her fault too.

"Cristina, you cannot scrub in on this one." Dr. Burke tried to persuade her but without success. Meredith noticed they were talking about who was going to scrub in on her case and she chimed into the conversation. Dr. Burke sighed loudly. This was getting better and better with every second. Of course, he meant that in a sarcastic way, not in a normal way.

"I want Cristina to scrub in. She is the only one I can trust, besides Derek. But he is not an intern so it´s going to be Cristina on my case. Also, the others don´t know. So I want Cristina."

"Grey, you are the patient, so act like one. I am your resident ..."

"You said I am the patient." Dr. Bailey shot her a glare and immediately Meredith was quiet. "I am your resident, Grey and Yang and I get to decide whether you ..." She points to Yang, who looked to the ground uncomfortably and shifted to the side, obviously nervous. "... get to scrub in." "But, Bailey, it is my heart and Cristina is great with hearts. She loves cardio." Meredith tried again. "Thank you, Mer. Really." Cristina told her ironically. "You are not an easy patient. I hope you know that, Grey." Bailey told her intern. "So, Let's get back to the important things. You asked about your echo, am I right?" Dr. Preston Burke asked his patient. Meredith nodded.

"I think you should do one. Bailey already told me that I should not tell you how to do your job, but..." Meredith smiled faintly.

"Is it okay if I do it now?" He asked. "Carry on with it." Meredith replied. "I know the drill." "You sure do."

Dr. Bailey disappeared. Dr. Burke was ready to take over from here.

Dr. Burke saw after his colleague for a few seconds, then he went back to his patient, who was waiting impatiently to begin his echo. Before he began, someone knocked on the exam room. "Come on in." Dr. Burke said and Dr. Webber was standing in the doorway. "Is it okay if I..." He asked. Meredith nodded slowly. Derek was here too, there is no way in hell he would let her go through all of this alone.

"Okay, now I'm performing the echocardiography to get a more detailed overview over Grey's current state."

Meredith rolled her eyes, but Burke could not see that, 'cause she was laying in side position. He reached for the transducer, what is also known as a Sector scanner, it formes from the point source a fan-shaped, diverging sound field. In the transthoracic echo - and duplex sonograph they use frequencies between 2 - 3.5 MHz. The nose of the transducer is used for orientation.

He pressed the gel on the transducer, the monitor was now white instead of black and put the nose of the transducer on Meredith' chest. He was highly concentrated. Dr. Burke looked at the heart of the apical four-chamber view. The transducer is above the apex (apex cordis).

The nose of the transducer is pointing laterally (left shoulder). The sound plane runs towards the base of the heart. As a result, the left ventricle is shown on the right side. The transducer is tilted by Dr. Burke anteriorly toward the aorta (thus also tilts the scan view). Now, the beginning of the aorta ascendes, left ventricular outflow tract and aortic valve is displayed on the screen. Dr. Burke did not say anything. Then something caught his attention: it was not a healthy heart, what he had on the monitor in front of him.

Meredith was a heart patient. She has had an Atrial Switch procedure in a young age. Her right ventricle was pumping her blood through the circulatory system. Yesterday he hadn´t even suspected that he would be here, in a room in the CICU staring at a monitor at Meredith Grey´s heart.

Dr. Webber´s eyes were fixated on the Monitor. He knew that she had had an Atrial Switch Operation, but it doesn´t Change the fact that it is real now. It could be seen on the Monitor. "Damn." Burke exclaimed, with a slight shock in his voice. Now he knew why Cristina had behaved so weird, the excessive research on the DORV and the IAA. It was because of Meredith.

He knew that know, 'cause he had been paged when she coded.

"Chief, look, here." began Dr. Burke, his finger pointing to the baffle, a pant-shaped atrial tunneling via the passes via the over the systemvenöse blood into the left ventricle and the pulmonary artery. The pulmonary vein blood flows past the tunnel into the right ventricle, the blood pumped through the aorta in the systemic circulation. The right ventricle was pumping blood through the body.

"What the hell ..." exclaimed Dr. Webber when he took a closer look at the monitor. "Is that right there a malposition of the great arteries?" Dr. Burke responded with a nod. "Why was not Arterial Switch performed? That surprises me." Preston said. Meredith responded sighing: "Arterial Switch wasn´t an option for me because of the ventriculo arterial unconformity and atrioventricular concordance. That is the reason why they did not do a Jatene procedure."

Dr. Burke nodded. That seemed right.

"But have you thought about a Secondary Arterial Switch Surgery. It could improve your quality of life, your left ventricle will be the chamber that..." "... pumps the oxygenated blood through my system. I know. I have thought about this option, but honestly? It is major surgery. Again. And I won´t do that again, if I don´t have to. When my right ventricle is failing we can talk about that then. But now? My answer is no. No Secondary Arterial Switch until my right ventricle fails to do the work it´s supposed to do." Meredith told him, while squeezing Derek´s hand softly. He felt that she was nervous.

It was obvious that Meredith had been on the operating table more than once.

Dr. Webber looked at the screen, trying to remember if Ellis Grey had spoken in her internship times about it ... But, no, never had someone told them that Meredith has heart disease. Never. Until now. Until the emergency meeting with Cristina, Dr. Miranda Bailey and Meredith, who finally told them about what was wrong with her heart.

Dr. Burke echoed further, the apical two-chamber view, he turned the transducer by about 90 ° counter-clockwise until the left ventricle and the mitral valve were to be seen. The nose of the transducer pointed to the right. Everything seemed unobstrusive at the first glance.

Again he looked closely on the screen where a heart could be seen.

Then, at the apical three-chamber view (RAO- equivalent) Dr. Burke spun the transducer from the two-chamber view more counter-clockwise about 30 degrees in the direction of the left ventricular outflow tract. It is possible to see and evaluate the following structures / organ functions: Presentation of the anterior septum and the posterior wall inferior-, assessment of the mitral valve and the aortic valve. The everything looked okay, he was. The heart surgeon looked at the heart in the parasternal longitudinal cut is the optimum transducer position in the left 2.- 5th parasternal intercostal space.

The nose of the transducer is placed to the right shoulder. So the heart surgeon can assess the following structures / organ functions: mitral valve, aortic root tract / aortic valve, left atrium (atrial size), parts of the left and right ventricle and proximal septum might pericardial effusion.

Then he viewed the heart using M-mode, a time-motion method, which is the representation of the echo of a continuous sound beam as a function of time. There are precise measurements of the diameter right ventricle end-diastolic and end-systolic thickness of septum and posterior wall, the end-diastolic and end-systolic Ventricle diameter.

A faint 'Whoosh Whoosh' could be heard in the room.

It was perfectly quiet, so Dr. Burke can hear the sounds of Meredith' heart. All eyes wered fixated on the monitor, except Meredith' and Derek's eyes. He tried to comfort her, to distract her from what´s happening.

Therefrom Dr. Preston Burke calculates the right ventricular function. Now he echoed the heart in the suprasternal area (from the neck). The transducer mark shows towards the head of the patient with a 45 degree rotation to the right. On this scan he can view the aortic arch, the carotid arteries and partly, the pulmonary artery and the left atrium are presented. After he finished the echocardiography he laid the transducer back holder connected to the ultrasound machine. He turns to his patient, she seemingly already knowing what he was going to tell her.

After all, Cristina did an ultrasound a few weeks ago, right after she told her.

Meredith slowly sat up, feeling a faint wave of dizziness hitting her almost instantly.

There they discovered, or Cristina Yang discovered that Meredith' aortic valve is stenotic and extremely narrowed andd that she might need surgery to correct that. She remembered that only all to well. Dr. Burke cleared his throat, suddenly Dr. Webber´s pager shrieked and he had to leave. The cardiothoracic surgeon waited until the door is closed again, then he starts speaking: "Well, unfortunalety I´ve discovered that your aortic valve is narrowed extremely and from what I have seen there is also subaortic stenosis, which makes the whole thing worse than it already is."

Meredith paled when she heard those words.

_Subaortic stenosis?_

_He is kidding, right... He just has to be..._

_Could this be true, possibly true?_

_What did I do to deserve this?_

Derek did not know what to say. Really, life always throwed all this crap at them, or mostly it´s her, Meredith. He tries desperately to stay strong for Meredith, because the very last thing she needs is him breaking down. So he needs to stay strong. To be strong, for her and his sake he has to be strong. He slowly runs his hand over her arm to show her that he is there for her and won´t let her go through all of this 'whereever this whole thing might goes' alone.

Dr. Burke continued with a stern voice. Cristina felt the sudden need to run away and cry, even if it´s unlike her. How could she missed this? How could she possibly have missed this? "I am sorry." She whispered with a shaky voice, feeling incredibly guilty. She should have seen this on the last two echoes. It is her fault. Her fault. These words were repeated over and over in her head.

"The gradient of the aortic stenosis is 50 without stress. How the gradient will be then, we will know after the stress ECG." Meredith just nodded. She knew this result of this wouldn´t be good...

* * *

Izzie was standing near the nurses station and completed some charts. She wondered where everyone was. Cristina was gone, Meredith was gone, George was somewhere she did not know where, probably on rounds or in the OR or something like that. "Oh, God, I hate my job sometimes." She muttered to herself. Suddenly George was standing next to her and asked: "Where is Bailey?" Izzie rolled her eyes, then attempted to answer.

"Oh, you mean the the ´Nazi´. Don´t know, kinda don´t care. Just ignore me. It´s just that I hate charting." George looked at Izzie´s blonde hair, that covered her neck and her back. George answered: "Please, be a little more helpful than just saying that you hate today´s shift." Izzie sighed repressed and just shrugged. "You are being not helpful."

"Crappy day..." Izzie wanted to continue but something caught her attention. It was a nurse who talking with another nurse. "Crappy day that mighht even get get crappier." She mumbled to herself. "What are you saying there, Iz? Talk to me." George urged her, tried to get her to speak to him. They are gossiping, what did you expect. we´re at Seattle Grace Hospital. The nurses are apparently always chatty, no matter whether they are on different services.

"Did you hear about Grey?" "No, what is with Grey, I haven´t seen her today, even though she has signed in on her shift." The black- haired one whispered, she in gossiping- mode. Some of the many perks and curses of working at Seattle Grace Hospital. "Do you wanna know what I heard from my friend and colleague Colleen, who works in CICU?" She took a meaningful pause and then continued with talking or better, gossiping. "Spill, I wanna hear." The other one said, leaning towards her friend. "So, they say she is lying up there in Cardiac ICU. Apparently, she passed out or something." "Well, if she can´t handle seeing blood, she should take another job." "Well having Ellis Grey as a mother, isn´t always enough." They both laughed. Izzie felt her blood boil. How could they dare talk about their friend like that?

_What the hell are they talking about. They said the name Grey, maybe they´re talking about Meredith. Now that was the only possibility. _

Izzie looked at George, who had the same confused look on his face as her. "Are they talking about Meredith? Do you think that?" George mouthed iritated. Izzie shrugged. She did not know what they are talking about. "Ask them." George hissed. "Why should I, Bambi, you ask." Izzie gave back, not letting this one sit on her. George threw her a tortured gaze and decided whether he should ask or not.

He decides against, and Izzie huffed as she realized that.

So she did it herself.

* * *

**_A/N: I know, normally I update this story every Tuesday, but looks like its now Monday. I hope you liked this chapter and please review... I´d really appreciate that. Thanks for reading. (Jatene- procedure is the same as Aterial Switch Operation, it´s just another name for it...)_**


	13. Chapter 13

**Chapter 13**

* * *

**How much can you actually accomplish in an hour? Run an errand maybe? Sit in traffic? Get an oil change? When you think about it, an hour isn't very long. 60 minutes. 3,600 seconds. That's it. In medicine, though, an hour is often everything. We call it the golden hour. That magical window of time that can determine whether a patient lives or dies. An hour. One hour can change everything forever. An hour can save your life. An hour can change your mind. Sometimes an hour is just a gift we give ourselves. For some, an hour can mean almost nothing. For others, an hour makes all the difference in the world. But in the end it's still just an hour. One of many. Many more to come. 60 minutes. 3,600 seconds. That's it. And it starts all over again. And who knows what the next hour might hold?** Meredith Grey; Golden Hour

* * *

"Wait." George stopped the blonde doctor, before she could do anything overhasty. Izzie stopped when George O'Malley tightened the grip on her arm, trying to keep her from doing what she was planning to do. "Be quiet, Izzie. I wanna hear what they say. You have to be quiet." George whispered in her ear. Izzie nodded. The nurse glanced at them before turning back to her colleague and asked her to continue. "She said something about Grey laying in CICU." Izzie's eyes widen instantly when she heard what the nurse was saying. George was standing there speechless. Maybe, he thought, he misunderstood what they were talking about, but a short glance to Izzie confirmed him that he wasn't wrong. He did hear it right. Izzie heard the same thing he did. And that was more than shocking. Izzie was standing there, the ballpoint pen still clutched in her fingers, while she was listening. It was shocking. They both couldn't believe their ears. There had to be a mistake, something they were missing ... maybe. Maybe not. Maybe it was the simple truth. Izzie's thoughts were overwhelming her. There were questions forming in her brain that slowly registered what she just heard.

Meredith was admitted to the Cardiac Intensive Care Unit? They have to be kidding. She would knew if something was wrong with her, wouldn't they be paged? They were friends. Why wouldn't they be paged if it concerns one of them? Izzie shook her head in confusion. Was Meredith really being treating in the cardiac intensive care unit of Seattle Grace Hospital? "Do you think this is really happening?" George suddenly whispered.

"Do you think that what they say is the truth?" He asked. Izzie first didn't respond to his question.

But then she remembered Grey and Yang's weird behavior back in the exam room, where she opened the door without knocking.

Maybe that was the key to all of this ...

"She told me that Grey collapsed while she was in the Chief's office. Maybe she did something wrong and the chief had to call her in for a meeting. I think she couldn't handle him being angry with her and just ..." The nurse put a stack of charts on the table while her friend looked at her with wide eyes. "What? She collapsed? In the Chief's office? Oh, my ..." The nurse replied shocked at what she just heard.

Izzie couldn't believe her ears.

What the hell are they talking about? They don't know a shit about Meredith, but she had to admit that she did not know all about Meredith, although she, her and George were roommates. But that doesn't say anything. They did not know a little, important detail. Meredith was hiding it from them for some unknown reason. That she was born with a life-threatening heart condition that could have killed her without surgical intervention. They didn't know that. That she had open heart surgery in order to survive and get as far as she has gotten today.

"She collapsed?" George was alarmed. "Oh no this doesn't sound very good."

Izzie did not answer. "I knew something was going on..." She mumbled, but decided not to continue.

The laughter of one of the nurses brought her back to reality. "Okay, it was fun talking to you I have go, see you later at Joe's for a drink?" "Yeah, I'll be there. When does your shift end?" She wanted to know. "Seven thirty and you?" She got as a reply, not really giving a shit about the intern they just gossiped about. "The same. So, drinks at Joe's after work?" After her colleague and apparently, also friend confirmed one of them left. The other one continued to type something.

Izzie looked at George, who was writing something down in a patient chart.

"Come on do it." She tried to persuade him, but just ignored her. "Why do I have to do everything myself." She exclaimed and George began to laugh.

"You sound like Cristina."

"I don´t." Izzie glared at him warningly, before she leaned over the counter towards a nurse who was sitting there and she was staring with interest on the screen of a computer.

"Hey, you." Izzie called out, causing the nurse to look up.

"What do you need?" She answered, not exactly looking up from what she was doing. "What did you talk about just now? Why were you talking about Dr. Grey? And don´t say you don't know what I want, 'cause you know. I know it and you know it." Izzie confronted the nurse. "So tell me what you know." She glared at the nurse. "I... I..." She stuttered, obviously taken off guard. "It's just me, an intern. Everybody at Seattle Grace knows how chatty you are. No offence, but..." Izzie showed a small, fake smile.

The nurse sighed and began to speak, but was interrupted by Dr. Sloan, who started flirting with her. Soon she was distracted by his cocky appearance. Then he turned his attention towards George and Izzie, who looked both a bit overwhelmed, when he asked them where Yang was. George answered the question of the attending from plastic surgery: "We don't know, we haven't seen her around. Maybe she is in the OR gallery watching some interesting surgeries, though somehow we doubt that."

"Do you by any chance where Bailey is? We were wondering where she is and we couldn't find her." Izzie interrupted George's rambling with a question. Mark Sloan did not seem very interested in her question.

"Have you tried paging her?" Mark tried to be helpful.

"A few times. But she did not answer any of her pages ... So we were wondering ..." "You already told me you were wondering where she is. Sorry, I do not know. Have you seen Yang? She has to finish her patient notes." Sloan said. He didn't know about Meredith yet. Otherwise he would have done them himself. "Like I said, no idea." Izzie simply replied.

"Very helpful. Impressive. Keep that up." He answered them, sounding a bit sarcastic and disappeared over the floor.

Izzie rolled her eyes at the plastic surgeon, who seemed very full of himself, but what they did not now was that mostly Mark´s behavior was just façade and not the real Mark behind it. He kinda was like Meredith, they had some parallels like the sleeping around and crappy childhood thing. Then Dr. Bailey stood behind them and caught them doing things they should not be doing during working shifts.

"What are you doing? Don't you have somewhere to be right now?" She asked sharply, not even bothering to look at the lab reports George had in his hand.

"Dr. Bailey, I have your lab reports." George O´Malley told his superior, who acted somewhat weird.

"Give me that." She snapped at Izzie who was holding an apple in her hand. "Don't eat that now. You have breaks to do that. Now you've got to see patients. And I give you some advice: Don't mess with me today. I am in absolutely no mood to deal with that." She gave them the famous Bailey look. Izzie and George were confused. "Now, hustle. You have things to, things I want off my plate. I have more pressing matters to deal with." She glared at the both of tehm intimidatingly.

Something really _was_ different, and it had to do with Meredith for sure.

It was always Meredith when comes to that.

Always.

Izzie pinched her eyebrows and eyed Bailey. But there was only one way to find out. Asking her.

"Has it to do with Meredith? Sorry, we've just heard some rumours about her being admitted to Cardiac ICU."

George waited for Dr. Bailey's reaction after Izzie confronted her with what they had heard. "And don't even start saying it is none of our business. It is. She is our friend and we care about her."

Dr. Bailey looked at them almost empathically and finally she answered: "I know you people care. But I don't think it's my place to tell you. Also, the rules of patient confidentiality apply here. So, not a chance. So, O'Malley, I need you to cover my post-ops and do the discharges." He nodded and followed her orders. Izzie on the other side wasn´t about to let this be. She was determined to find out why everyone was acting weird.

"Dr. Bailey, just tell me."Izzie pressed.

Wanting attention from her resident who was already stressed due to some for her unknown problem / cause.

"Who is your attending. On whose service are you on?" She asked.

"I am supposed to be shadowing Yang and Sloan, but neither of them are here or anywhere to be find. Except Sloan, but he kept asking for Yang." The blonde doctor said.

"Go help O'Malley with today's discharges and post-ops. I have more important things to do. Meaning, I am not gonna babysit the two of you nor do I have time to do that. I have to take some blood work down to the labs." Bailey said and before they knew Bailey was already running down the hallway in a hurry. "Ok, what was that?" Izzie asked. "Why is she acting like this?" She asked. George was baffled as well. Izzie was now very confused, but she knew something was wrong with Meredith.

* * *

Meredith was about to get on the ergometer. They already did a pulse oxymetry to see how high the the amount of oxygen in bloodstream is. After the time on the ergometer they will do another pulse oxymetry and a repeated blood pressure measurement. Now they were about to start the stress echo to see how high the gradient is under high pressure. Dr. Burke already did the short-time electrocardiogram, after the stress ECG they have to do an long-term echocardiogram over 24 hours. As a child she had always hated that. In fact, she was fairly sure she hated it now as well. "Come on, Mer. You need these tests to determine the severity of your condition." Derek said, trying to be helpful.

"Yeah, I know why I need those tests, doesn't mean I have to like it."

Meredith turned away.

Now everything was starting again. She had been so sure that she was through with it, finally but apparently there were more hurdles to jump through before she could live ... just live. Like anybody else ...

"Now we have to do the stress echo." Burke told his patient, even though he knew that she knew the proceeding.

There were several ECG leads and electrodes connected onto her chest. Each ECG lead was marked with another colour to differentiate the ECG leads and to make sure they are connected to the right point, otherwise there could be incorrect polarity reversal of the ECG derivations if for example green is switched with the yellow lead. That could lead to a wrong diagnosis, just as muscle potentials (usually mentally or disease-related trembling), AC superimposition and motion artefacts causes non-evaluable ECG recordings that can't be interpreted by a physician.

"Grey, are you ready? I'll increase the resistance every minute, so it will be a lot harder for you to hold the rate between 25 - 30. 30 is the limit, if you are over 30, slow down, but don't stop. Otherwise we have to repeat this." Meredith nodded, She knew how this worked. She sat on the ergometer, waiting for Dr. Burke's sign to start with pedaling. "Ok, Grey, I'll start recording the electrical activitity of your heart."

He was sitting behind a computer, where he could see the recorded heart rhythm of his patient.

Also her systolic pressure gradient and blood pressure could be monitored closely.

"Go." Meredith began pedaling. At first it was very easy to hold the tempo limit between 25 - 30. But then Dr. Burke said: "I'll increase the resistance a bit. Please try and stay in the range between 25 - 30. If you notice any discomfort, dizziness or anything else, like trouble breathing let me know. Then we'll stop before you pass out. But that would be worst-case scenario." Derek watched her worried, not letting Meredith out of his eyes.

Meredith slowly nodded. She used all her strength for pedaling. It was getting much more difficult to get enough air into her lungs. Her breathing got heavier with each second that passed. Derek's gaze turned to the poster that was hanging on the wall, displaying the different kinds of arrhythmias.

Ventricular tachycardia.

Ventricular fibrilliation - practically cardiac arrest.

Supraventricular tachycardia ...

Sick Sinus Syndrome. Premature Ventricular Contractions.

Complete heart block.

Atrial fibrillatio.

... and lots of other arrhythmias. Some life-threatening, others not ... Then he got distracted by Dr. Burke who was sitting in front of the computer recording Meredith's heartbeat. "Is everything okay?" He asked. Burke never gave him a decent answer.

"Dr. Burke." Derek pressed firmly. "What's going on?"

Dr. Burke stared at the monitor, then at his patient. Derek was looking at Meredith worriedly. She was pale, her lips slightly blue. Tha could only mean that she wasn't getting enough oxygen. Also the aortic valve gradient increased rapidly. It went from 50 mmHg up to almost 90 mmHg, which was too high, a lot to high and considered as a serious aortic stenosis in the need of surgical intervention. Meredith could not concentrate on staying within the asked range. She was pedaling but not in the range between 25 - 30. She was much slower. "Dr. Burke. Shouldn't we stop the reading?" Derek asked as he watched Meredith breathing loudly, gasping for air.

Struggling.

Breathing wasn't supposed to be that difficult.

He nodded. This was it. He wouldn't watch this any longer. Dr. Burke noticed the struggle his patient had and stopped the recording. Meredith could hear Dr. Burke's voice as if he was miles away, when he told her to stop immediately. Meredith tried to control her breathing. Dr. Burke reached for an oxygen mask and strapped it over Meredith's mouth and nose.

Slowly, her breathing normalized.

"I am fine." She told them having trouble catching her breath, knowing herself it was a lie.

Derek looked at her as if she had lost her mind.

"Don´t even think about trying the I'm fine - thing here, Grey. Your test results show something is not right." Dr. Burke told his patient, a serious look covered his face. Almost, a grave-like look was gracing his features. Derek swallowed harshly. None of this was fair. Not to Meredith. "I am sorry, Grey, that I don't have better news, but we need to order further studies unless we can say something definite. But looks to me like you will need surgery, probably soon."

Meredith gaze wandered through the room, avoiding everybody in the room. No. This could not be true.

"What studies?" She asked, her voice shaking slightly.

He cleared his throat before he answered: "Well, an electrophysiological study of course, but we already scheduled that and then maybe stress echo and a heart catheter. Again I am really, truly sorry that I don't have better news for you." He glanced towards the neurosurgeon who looks like he could not believe it. It was an unescapable moment.

Meredith seemed like in daze, like she faded the others in the room out ...

* * *

Cristina had left the room. She had been paged to the Emergency Department, although George was covering, but they paged her instead of him. When she entered the pit, she did not see any major traumas or any other patients. Cristina made her way to the ER registration desk and asked a nurse. "I was paged to the pit." She said. "But I don't see any traumas around here." She concluded. Before the nurse could answer, another voice interrupted the beginning answer of the nurse sitting on the registration desk. Cristina breathed in deeply. She'd rather spend time with Meredith, especially now. Now she needs her person and Cristina wasn't about to let her go through this mess alone.

"Well, but we have a trauma. Orthopedic case. Come with me. I am kind of babysitting for Dr. Bailey." A voice behind her back said almost monotone. Cristina turned around and saw Callie Torres, ortho resident in the same year as Dr. Bailey and maybe- girlfriend of George. The orthopaedic surgeon glanced at her and motioned her to follow her.

Ortho?

Really. Orthopaedic surgery? Hopefully there will be a surgery.

But on the other side ... Orthopaedic surgery is boring. Why does it have to be ortho?

"Where?" Cristina asked.

"You'll see, Yang. Believe me, ortho is fun." Callie tried to make an attempt to make Cristina rethink her negative opinion about orthopaedic surgery. "Breaking bones is fun? Says who?" Cristina gave back, not in the mood for perky persons, even if Callie wasn't a very perky person. Izzie was perky and sometimes annoying. Thank god that she wasn't working with her today. "Don't even go there, Yang. Just because you had a bad day you don´t have to spread your evil whatever here." Callie scolded her, not exactly knowing what happened.

If she had known what happened, she wouldn't have said anything.

Cristina almost laughed. She did call her day bad?

Well, that was the understatement of this fucking year. It was an understatement, really. Only Callie didn't know. How could she know? She wasn't there when it all happened. Callie observed Cristina's weird behavior. Then she made a decision to end this conversation at this point and get back to their patient.

"So, let's get back to our patient who is laying there in pain. So, if you don't mind, Yang, I'd really appreciate getting back to work now."

"You paged me and then downplayed my day which was wrong, 'cause my day was bad, very, very fucking bad. Well, not as bad as Meredith's day, but watching your person collapse in front of you isn't something you take lightly. Even if I am Yang and sometimes roboter-like. Now, you said something about treating the patient, let's do that." Callie looked at her, trying to process the words. So that was what was on Cristina's mind. She was worried about her friend. That must be the reason for her being even snarkier than usual.

"Is she okay?"

She couldn't not ask.

Cristina laughed without happiness.

"Of course she's not okay. What do you think? Her right ventricle is pumping the blood through the body. Of course is she not okay." Cristina exploded, all the pressure she felt was now ...

Callie swallowed hardly.

But then decided not to ask any more questions about Meredith and her current situation.

* * *

"Grey?" Dr. Burke asked worriedly. "You hear me?" Meredith was just sitting there, shocked. Fading the others out. She inhaled and exhaled deeply. She didn't look up at all. "Shall I page Cristina? Let her deal with this? She's the only one who can ... who speaks _Grey-ish_." "That's not necessary. I'm perfectly fine. Let's get this over with." Meredith shrugged, awakening out of her stupor. Dr. Burke and Derek watched her attentively. "You sure you okay? You just spaced out for quite a time." Derek asked, worried. This was making him worry. Meredith gave him a smile, the one she only reserved for him. They were about to begin with the recording of the long- term electrocardiogram. "So," the cardio-thoracic surgeon said, looking at the neurosurgeon sitting next to Meredith. "I have to do some important work- related things, but I will be back to check on you. Derek." He adressed. He looked up.

"I expect you to page me if anything seems to be going weird. If something ... anything happens."

"i won't take any risks with the person I am meant to be together. I'd never do that." He answered, smiled slighty at Meredith, who mouthed: "I love you, Derek Shepherd."

Dr. Burke did not know what he felt when he left the room.

This was scary. He might has to operate on a colleague and a friend (he considers her a friend since she and Cristina are practically inseparable), someone that was respected by everyone ...

This was something to be scared off. He was scared of screwing this up.

This was Cristina's person.

Somehow that's ironic. Cristina loves cardiothoracic surgery and her best friend has a congenital heart condition. Doesn't that sound ironic? In some way, it does.

Within a few hours everything changed. He never thought that Grey, the daughter of the famed Ellis Grey, suffered from a life- threathening heart defect. That was, he did not even know what that was... He didn't know how many hours ago he was paged to the Chief's office due to an emergency involving one of their own. He couldn't believe it when he entered the room. He couldn't. But it explains Cristina's behavior over the past view months. Her research about congenital heart defects and so on. It all makes sense now ... He sighed.

Meredith leaned against Derek, her head on his shoulder. Her breathing was even, she seemed relaxed. As relaxed as someone could be in a hospital and about to undergo a surgical procedure. Derek was happy about that. "Meredith." He asked, wanted to know whether she is awake or sleeping. Her reply was a soft _Hm_, it was all he could get out of her. But that was okay. It seemed like she dozed off. Derek breathed in deeply, his arms embracing Meredith's slender form. He breathed in her lavender scent. A small smile came over his face. A little normalcy in all the chaos. After a while, Meredith moved gently, but her eyes stayed closed. Then suddenly she groaned loudly and then started shifting her head abruptly.

That was causing her to open her eyes and cry out in pain.

Derek was freezed.

No. No, this cannot be true... Crying out means she is in pain...

Suffering...

What is going on with my Meredith? Why is she crying out like she's in pain?

Isn't a potiential surgery not enough? Does also have to be that? He needs to ... needs to ... page Burke, yes that is what I need to do.

"What is it, Mer? Tell me, so I can help you." He said, trying desperately to suppress the shock and worry in his voice. Meredith could barely her him. There was just pain, pain that faded everything else happening out. She couldn't concentrate, couldn't think. He needed to stay focused, he needed to page Dr. Burke. He told him to page him whenever something seems to be going wrong. And now, Meredith was in pain. He could see it in her gorgeous eyes, which were normally full of life.

But now they were dull and a pained expression covered her.

"Make it stop, make it stop. Derek, please." Meredith whimpered, her eyes hurt when they hit the light.

"Where´s your pain? Meredith. Meredith." He started an attempt to get her to focus on him. When all the talking did not help, he took her face in both of his hands. Meredith squeezed her eyes shut, the sudden sensitivity to light irrtated her. "Meredith, I need you to focus on me. Can you do that?" Derek asked tensely.

"Head..." She whispered softly, followed from a quiet moan. "... hurts."

She lets out a suppressed sob, the pain in her head was excruciating. She grimaced and rubbed her temples.

"Okay, Mer, it´ll be better soon. I promise." Derek told her, grabbing his pager. "But you need to calm down, the crying will intensify the pain only." He noticed her pale face and the sudden need to embrace her and take all her pain away...

* * *

_**A/N: I'm sorry for this being so Izzie and George centered. The next chapter will be MerDer again. Hope you liked it. Please review.  
**_


	14. Chapter 14

**Chapter 14**

* * *

**Say you're in the O.R. repairing a vena cava, when suddenly, everything goes to hell. So you cut this, suture that and soon that crappy situation is a thing of the past. Too bad you can't meet all of life's challenges with a surgical scalpel. I mean, you could try. But I'm pretty sure that'd be considered assault. It's a little bit horrifying just how quickly everything can fall to crap. Sometimes it takes a huge loss to remind you of what you care about the most. Sometimes you find yourself becoming stronger as a result, wiser, better equipped to deal with the next big disaster that comes along. Sometimes. But not always. **Meredith Grey; Heart-Shaped Box

* * *

"Then why are you still working?" Callie asked her intern, as it seems she rethought her decision about Yang not asking questions about Meredith. "I am working, yeah... that is right." She said, looking at Callie. "We´re already two doctors down, so it´s not the best time for stopping to work although I´d rather be with Meredith, but I also think Derek´s good company." Cristina answered the orthopedic surgeon´s question. She then noticed Callie´s face that showed nothing but disinterest. "I am talking way too much, am I?" Cristina then asked her superior.

"Damn right you are!" Callie almost laughed, but stopped by the look on Cristina´s face. She looked like it was far from being funny. She understood that. Then they attended to their patient. After treating him, both of their pagers shrieked. It was the Emergeny Department. Again. Cristina sighed, she would have wanted to visit Mer in Cardiac Intensive Care Unit but now she was stuck dealing in the ER dealing with creepy, uncooperative patients, when she could have spend this time with Meredith, who was now more important than some potiential surgeries...

"What is it Yang?" Callie Torres asked, glancing at the intern, who was pacing up and down on the floor, obviously a little preoccupied. "Yang, come on. Haven´t you heard that they paged us to the ER? No, come on." Callie Torres commanded.

"Stupid little ER page." Cristina muttered to herself.

She motioned her intern to follow her, which she did, actually. Even if only reluctantly, she did follow the orthopedic surgeon.

Alex was already there, holding something in his hands that looked like a patient chart. "Okay, were do you need me?" Cristina asked. "Go help Karev with his patient." Callie ordered. "Why? He is totally capable of treating a patient on his on. There is no need for me to butt in there." Cristina protested. "You´ll do it, Yang, because I told you so. Now, go or you´re on scut for the rest of the week." That convinced Cristina and she joined Alex Karev, who was clearly not happy to see hear butting in. Cristina ignored him or more precise, his grumbling.

"Yang. What do you want?" He grumbled. "I am just here because of O'Malley´s girlfriend ordered me to. No need to bitch around, evil spawn."

"I don´t need you to babysit." Alex did not give up.

"That´s what I said. I would rather be with ... " Alex laughed. "Don´t say you want to be with Burke in an on-call room, 'cause that would just be horrific." "Shut up." Cristina shot him a silencing glare. Alex shifted uncomfortable. The patient, a young girl with long brown, almost black hair, watched them amused. "Now that is better than Soap opera." She said, interrupting the bickering.

"Oh. I am truly sorry for that. Please ignore our lack for professionalism. Normally, we do not argue in front of patients." Cristina excused their behavior in front a patient. "Never mind. I am happy for some distraction. But would somebody please attend to my sticking head wound, so that I can get out of here?" The patient asked, eyeing Alex with her brown eyes. Cristina shot Alex knowing glance. This girl was kind of flirting with Alex.

Suddenly a nurse was shouting: "We have a pediatric cardiac patient coming in. We need a doctor."

"I am available." Cristina was determined to get in on this. She loved cardiology and cardiac surgery more than any other specialty.

"Okay, Yang, Change of plans. You go treat this peds patient and if necessary, page Burke." Callie seemed like she was a bit in over her her head with all of this activity in the Emergency Department of Seattle Grace Hospital.

"Yes." Cristina called out. "Thanks, Torres. That´s exactly what I need to keep my mind of Meredith." Cristina was already on her way over to her patient. "Don´t make me regret it, Yang." Callie called after her, then she sighed. Cristina introduced herself to the patient and his mother. The patient was about ten years old and looked like he was having some sort of Asthma attack. She grabbed the boy´s patient chart and found herself reading in it: _Casey, aged ten, asthmatic and had a febrile seizure at the age of three months. _

"Page pediatrics and cardio right now." She ordered, while she took a listen to the boy´s heart. She also ordered some x-rays. After the x-rays were done, the pediatric surgeon who was paged down for a consult, arrived. But her cardio consult, who was Burke, wasn´t coming. He had been caught up in a Situation involving Meredith, but Cristina did not know that back then.

* * *

Derek was waiting impatiently for Dr. Burke to answer his fucking page. He can´t believe it is taking him so long to simply answer a damned page. And now it is obvious that there is a real emergency, though her heart is still beating. Luckily it is. "Derek, it really hurts." Meredith felt her headache intensify and groaned repressed, nearly starting to cry. Derek stroked her hair softly and tried to calm her down. Never in his life he had felt this helpless.

"Shhh, lt'll be alright." Derek tried to calm her down, in her Situation crying would only lead to intensifying the already unbearable pain she was experiencing. She only groaned in response as Derek started stroking her hair softly. Meredith somehow didn't believe him but the pain was too much to care about that. She just wanted to curl up and die.

Literally.

Then Dr. Burke entered the room, immediately seeing why he was paged. "What took you so long?" Derek was relieved to see him running through the door. "How long has her condition been like that?" He asked the neurosurgeon, ignoring the question Derek asked because it does not matter anymore. Derek looked at his watch. "Maybe five minutes, give or take." Derek answered.

"It looks like a migraine attack." He told him. Derek looked like he did not believe him. Migraine? Meredith was having migraines? "What? She doesn´t ... " "It can happen in People with congenital heart defects. We'll try and stop it." He then said.

"That would be nice, please hurry up with it, 'cause it really hurts." Meredith was looking at the cardiac surgeon, pain was written all over her face.

"But first I need to ask you a few questions." He said and was about to continue ... Meredith noddded and moaned slightly as a wave of nausea hit her. She tensed up automatically, trying to control it. But it did not work. She grabbed a bowl and retched in it. Derek supported her, but there wasn´t very much he could do. He waited for Dr. Burke to do something. "Do something." Derek urged him.

Suddenly, Derek´s and Burke´s pager shrieked. Meredith moaned slightly when she heard this sound. "Damn it." Derek mumbled, looking at Meredith, whose eyes remained closed. He couldn´t leave her like that. He was the neurosurgeon, he was supposed to do something about her headache. She shouldn´t have to suffer like she does now, but now he was paged.

What was he supposed to do? Yes, he will page Shadow Shepherd to do the consult. He wasn´t nearly as good as Shepherd was but there was nothing he could do about that right now, he would have liked to treat the patient himself but considering the situation he was going to stay with Meredith.

Suddenly Meredith lost consciousness.

She passed out, apparently the pain had been to much for her heart to take in.

"Meredith. Wake up. Mer?" Derek was frantic and called his girlfriend´s nme when he saw that Meredith' body has gone limp in his arms.

_No, that couldn´t be true. _

_Come on, Mer, don´t do this to me._

After two minutes, Meredith regained consciousness, her head pounded heavily against her skull and she was deathly pale.

They tried to stop Meredith's headache for like two or three hours. When they finally got it right with the pain medication and were able stop the migraine, Meredith was sleeping. Derek was sitting on a chair next to her bed and tried to cope with what he had whitnessed, he hated it when Meredith was in so much pain.

"If we´re lucky, the long-term electrocardiogram will show us some nice things." Dr. Burke said. "You mean, we might find the cause of her having such an aggressive migraine that caused her to pass out a second time this day. How much strain do you think her body can take?" Derek was focused on Meredith` face and the sinus rhythm on the heart monitor next to her.

"Yeah, good question, but for now this girl´s holding on. I think we might do the elctrophysiological study tomorrow and let her recover from this for now."

"That we should do, letting her recover from this will do her good and I do not want to put anymore stress on her if it is somehow avoidable. I'll sit with her, make sure, she´s alright. Will you tell Cristina? She deserves to know." Derek asked him to update Cristina on Meredith's condition.

Burke nodded. "Will do."

* * *

Cristina was treating her patient, when a furious Izzie stormed towards her. "Dr. Yang, can I talk to you for a minute?" She asked with a angry- sounding voice. Cristina ignored her, she suspected that this was about Meredith and she won´t talk to Barbie about Meredith, when Meredith did not want her and George and Alex to know about her heart condition. "Cristina." Izzie was talking to her. She ignored her but Izzie will not leave until she knows what is going on with Meredith and why is acting that weird.

"I cannot talk to you right now, Stevens. I am treating this patient." She answered, but gladly, the new pediatric surgeon finally answered her page. She turned towards her and got her up on speed on their patients condition: "Casey, ten years, asthmatic, presents with an Asthma attack, but you may need to take a look at his x-rays, 'cause from what see his heart looks enlarged. Excuse me for a sec." Arizona nodded and smiled sympathetically at the resident and the boy´s mother.

"I am Dr. Arizona Robbins and I am the pediatric surgeon on his case."

"Nice to meet you, Dr. Robbins." The mother said, her boy was still heavily wheezing with each breath.

Izzie grabbed Cristina's arm, determined to find out what is going on here. After they were alone in the interns locker room, she confronted the surgery loving intern named Cristina Yang about Meredith and the thing about the heart defects. "What are you doing? I have patients, Izzie. Let go of me." Cristina exclaimed, not knowing what the blonde doctor wanted. "No, I won´t, Yang. So, I know, you think it is none of my business." Izzie hissed. Her voice sounded angry. "'Cause it is not your business, barbie, you get that right?"

"No, actually, I don´t." Izzie yelled.

Cristina hoped that this wouldn´t take so long, she needed to get back to her patient. "Please, do not do this, Izzie. This is like the thing with Bailey and Webber when they cornered me and I won´t do it again. Especially not yet." Cristina rejected. Izzie did not care. Really, she just wanted to know what is wrong with Meredith. She grew up in a Trailer park and knew how to get people to talk and tell her what she wants to know.

_Nah, it is going to get interesting!_

_Say it, say it, just tell me __..._

"What is going on with Meredith?" Izzie asked sternly.

Cristina did not answer. She wasn´t going there, even if Izzie wanted to know and god, she knew this girl could be quite persistent and unyielding (Remember the thing with Burke´s scrub cap and Denny´s surgery...).

"I am not going to tell you, Iz." Cristina answered. "However, I need to get back to my patient." "No, you do not need to get back to your patient. You need to tell me what is happening with Mer. Why Bailey is looking like it rained for the past four months nonstop. Why is Dr. Webber pacing from one OR to another and bribing all the nurses to page him whenever something happened on some VIP patient in Cardiac Intensive Care Unit." Izzie ranted. Cristina looked at her with disinterest. "Good, you have made your point here." Cristina shrugged.

Before she could Izzie slammed her against the lockers like Meredith did with Alex when he opened his big mouth saying things that aren´t, well, from importance. Plus, he acting like a real jerk, which he is sometimes ... "Have you lost your mind? Do you want me to get a freaking concussion, idiot?" Cristina asked her shocked about what she did. "How long did you think you could keep it from us?" Izzie said. "We had to hear it from the nurses."

_What the hell does she think she is doing?_

_Has Blondie lost her mind completely? _

_The last thing I need is a freaking concussion, even if its just a minor one._

"Tell. Me. What. Happened. To. Meredith." Izzie slowly repeated.

"The question is, what did not happen to Meredith." Cristina mumbled, hoping Izzie would not hear her words.

Silence between them.

"Tell me." Izzie said sharply, pressing Cristina against the locker. "What am I supposed to tell you, Iz?" She then said. "Ah, don´t come me with that. I hate that. Just Spill it. Why is everybody so ..." She searching for the right words. "Please, Cristina, tell me. I am worrying." Izzie almost begged. "So am I." "What is wrong with her." "Okay, don´t tell her I told you, or you´re dead. Don´t confront her about it. Don´t, even if you are angry, 'cause I know you will be angry that she did not tell you." Cristina said her condition. "Okay, I won´t confront her or anything, just tell me. I am begging you." **_Pathetic._**

"Cristina, what is it? She is sick, isn´t she? Has she some kind of life- threathening, serious illness?" Izzie asked. "It is a CHD, Iz. She was born with a heart condition and now she needs a pacemaker and a new aortic valve." Cristina told her, waiting for her reaction. Izzie slowly released her hard grip on Cristina´s arms and looked at her in utter shock.

"You are wrong." She heard herself saying, she was definitely in denial. Suddenly Burke entered the interns locker room, searching for Cristina. "I have to talk to you." He said." "Oh no, please don´t tell me she coded again." "She didn´t, but she´s had a migraine attack we were able to stop, that´s why I didn´t answer your page. She is sleeping now." He ignored Izzie completely, he was shutting her out. "But she´s okay, isn´t she apart from the part where she needs the pacemaker, right?" Cristina wanted to know, worry filling her voice almost instantly.

"For now, she is stable." He said, his eyes were fixating Cristina.

* * *

**Flashback: Meredith Grey, four years**

_Ellis Grey continued to stare at her daughter´s Monitor. Her heartbeat was steady and almost normal, even though you can see a slight sinus bradycardie on it. But still, it was a Sinus rhythm and unless that changes everything´s in the 'normal' range. She was watching her oxygen Saturation and all the other vital signs precisely. After a while, a doctor from peds was coming towards Ellis. "I am Dr. Hee, your Otorhinolaryngologist_ _and will be the one treating your daughter, Ms ..." He introduced himself. Ellis looked at the paediatrician, then told him her Name, as well introducing herself with 'Doctor'._

_"Well, I am Dr. Ellis Grey, surgical resident at Seattle Grace and this little one..." She pointed at her already intubated daughter. "... is my daughter Meredith Grey. I brought her in with a suspected acute bacterial Tracheitis, but These morons called ER interns almost killed her by waiting too long before treating her. They´re sloppy and careless and I need my daughter to be moved to PICU right away so her condition does not deteriorate." Ellis was exasperated and half frantic, but calmed down eventually. __For a Moment she enjoyed the look on the doctor´s face. "She also needs a chest x-ray and x-rays of her trachea_

_A real doctor was here and taking care of Meredith._

_"Yeah. We'll move her right away. Nurse, organize the Transfer for this girl to Pediatric Intensive Care Unit." He ordered. "Will do it, Doctor." She answered and grabbed for a phone. After she informed Peds ICU that they have a new patient coming in from the pit, she gave the okay for moving. "I will come with her and I'll oversee everything you do. You´ve messed up enough." Ellis said professionally. _

_But the doctor shook his head rigorously. "No, you don´t. I understand that you are worried- " "That is the Understatement of the damn year. You waited two hours before treating her. That´s reckless. Moron, stupid morons, maybe I should arrange a Transfer for her to Seattle Grace." "- but you cannot ..." "I pretty darn can. Let me a least take a look at her x-rays." __"Come with me, Dr. Grey. You need to fill out some paperwork." The doctor said. "Can´t that wait?" Ellis asked begrudgingly. He shook his head. "No, it cannot wait. Come with me, afterwards, you can see your daughter." "Fine. But Let's make it quick, I don´t have much time. My shift starts in four to five hours and I want to stay with her as Long as possible."_

_"Make sure to get an intravenous access and start her on medication right now." The pediatric intensivist ordered. "Yes, Doc. What medication I should start her on?" "Just get the IV Access and let me handle the medication." Once the airway is stabilized, obtain intravenous access for initiation of antibiotics. The doctor started Meredith on Oxacillin that provides empiric therapy against etiologic agents, specifically penicillinase-producing strains of Staphylococcus. "If Oxacillin does not help, we'll start her on a dose of Vancomycin that may be used in severe cases or in cases with a history of allergies instead of oxacillin for coverage of gram-positive organisms."_

_But the Oxacillin helped. It really did. __It´s been three days since Meredith was admitted to pediatric Intensive Care Unit for an Acute Bacterial Tracheitis. The suspected diagnosis was confirmed with a_ _nasopharyngeal culture – the doctors took a sample of mucous secretions from the uppermost part of the throat and a tracheal sample to see if bacteria are present. They also did a chest x-ray of lungs and the trachea of course to rule out pneumonia. They found out that the Tracheitis was caused by bacteria named Staphylococcus aureus. _

_She could have suffered 'Toxic Shock Syndrome' with that kind of bacteria and that easily could have killed her if not treated__!_

_And it almost did when she coded, but luckily she did not caught Toxic Shock Syndrome ..._

_ Ellis was there between her shifts. Her sats improved every day a bit more. She was ready to be taken off of the mechanical Ventilator that helped her breathe when her airway was obstructed and she wasn´t able to do it herself. Now she was able to do it herself. The doctor on her case noticed that she was awake and fighting the vent when he came in to check her vital signs._

_"I need a status report on the current condition of patient Meredith Grey. Can you do that?" Ellis Grey wanted to know, her voice harsh. The young doctor freezed and nodded. "Meredith Grey´s been downgraded from critical to serious." The doctor informed her. "What do you mean with with that?" Ellis voice still sounded harsh. "We extubated her, her sats are improving and she´s been breathing on her own for two hours. It is great news._

* * *

Cristina looked at Preston, then at her pager. It shrieked again. It was Arizona Robbins who was paging them both. "Come on, Burke. They paged us. We need to go." Cristina said, leaving a stunned Izzie in her wake. Preston Burke followed her. "I looked at Casey´s x-rays. They clearly indicate that he has something wrong with his heart. It is enlarged. See." She pointed at the x-rays showing the thorax of the ten-year old boy.

Dr. Burke nodded approvingly. He saw the same as the blonde and very perky pediatric surgeon on this case.

"He definitely showes some cardiomegaly and see, right there, you can see signs of pulmonary congestion." He explains. Cristina looked at the x-rays. Yay, after all, she might get a heart surgery to scrub in on.

"Cristina, do an echocardiography and all other studies, I want to rule out ALCAPA." He ordered. Cristina nodded. "Will do." After further tests, they knew that Casey suffers from cardiac Asthma caused by Bland-White-Garland-Syndrome also known as 'anomalous origin of the left coronary artery from the pulmonary artery' or short ALCAPA. That means the left coronary artery (LCA) arises from the pulmonary trunk, the RCA arises normally from _Sinus valsalva_ of the Aorta.

With sufficient collateralization of the patient remains asymptomatic a long time. That is in about 15 - 20% of the cases. But this condition, the condition Casey was born with, is rare. So he will need surgery to correct this anomaly. "I´ll talk to his mother." Arizona offered with a smile. "Yang, care to join me?" Cristina did not have much choice if she wanted in on the surgery, so she said yes.

When Dr. Arizona Robbins and Cristina Yang entered the patient room in peds ward, the boy was staring at the wall, his breathing normalized. They set him up with medication against heart failure, until an OR gets cleared up. "So, we´ve found out what is causing the troubled breathing and the Asthma symptoms. He has Bland-White-Garland-Syndrom or short ALPACA. Dr. Yang, explain them, what this is."

Cristina nodded and reached for the patient chart, then she started talking: "ALPACA means that his left coronary artery is connected to the pulmonary trunk and therefore isn´t getting enough oxygen. We need to do a surgical repair as soon as possible."

The mother nodded. "Do it. Do the surgery."

"Of course we are going to do the surgery. But there are different types of surgery like Takeuchi- Operation, Tashiro- Operation and then there is also the Option of the ´Direct Implantation of the left coronary artery into the Aorta´. So, now is the question, Which option do you prefer?"

"Yang, it would be nice if you would speak in normal english." Arizona said with a frown from behind.

"Yeah, sorry for that. I will speak in normal english. The Takeuchi surgery is the normal choice of therapy, but there are other Options too. Before the surgery we will start treating the heart failure with doses of catecholamines, diuretics and afterload reduction." After Cristina explained everything to the mother, they discovered that an OR cleared up and the boy´s surgery got pushed. After he was put under, Burke let Cristina do the first cut.

"I am opening him up?" She asked. "Do it before I change my mind."

Cristina grinned and took the scalpel and made a long incision in the middle of the boy´s chest.

The failed outgoing left coronary artery is diverted through a tunnel to the aortic root. This tunnel flows is the pulmonary arterial sewn on the back wall. The Takeuchi- surgery is the most common surgical method. The surgeon on this case, which would be Dr. Burke and Dr. Arizona Robbins from peds, did a few millimeter wide window between the aortic arch and pulmonary artery. This connection between the two vessels is linked by a tunnel, which is applied to a wall of the pulmonary trunk with the ostium of a left coronary artery. "We are finished." Arizona said. Through the tunnel flows from now on the aortic blood in the coronary artery. A disadvantage is the development of a supravalvular pulmonic stenosis due to the tunnel by which the lumen is narrowed which can require re- surgery in cases.

After they finished the surgery they told the mother of the boy what to expect after the surgery and how the procedure went.

"How did it go?" The mother asked as soon as she saw the surgeons coming towards her. Arizona had a big smile on her face and started talking: "We were able to perform the surgery successfully and he will live a alomost normal life. But he needs regular follow- ups with his pediatric cardiologist." "Is he going to be okay?!" Dr. Burke nodded. "He is going to be fine. Do you want to see him?" Arizona then asked. "Yes, please." The mother grabbed her bag and followed the pediatric surgeon to the pediatric ICU.

When they disappeared, Cristina leaned over to Burke and said quietly: "The surgery was great. Why don´t we celebrate that?" He looked at her, his mouth twitched suspiciously. "Come with me." He said and opened the door to nearest on-call room ...

* * *

In the next morning Meredith woke up when she felt a slight motion next to her. It was Derek, his head was on her chest. She smiled and watched hum sleep and softly stroked his McDreamy- hair. Suddenly he opened wearily his eyes. "Hey, Mer." He mumbled, yawning. Meredith chuckled and traced with her finger through his hair. "Morning, sleepyhead." She greeted him. He slowly sat up, immediately recognizing where he was and why he was here and what happened yesterday.

"How are ya feeling?" He asked worriedly, remembering her pained expression all to well.

"Considering everything, I am feeling great. Is the EP study scheduled for today, McDreamy?" She asked, sitting up.

"It is, wait, did you just call me McDreamy?"

Meredith nodded, a playful expression covering her face.

"I did."

"I love you, Meredith, so much." He confessed. "I know, Derek. Otherwise you would have ran for the hills, after I told you. Thank for not running. Did you know that you are my hero?" She asked. "I did not." He answered, looking at his gorgeous girlfriend, who survived so much.

"You are, you definitely are, Derek Shepherd. You are a big, strong neurosurgeon who makes my day and you are what keeps me from just giving up. You and Cristina are everything to me." She told him with a serious voice. Derek smiled when he heard those words. He always knew Yang was just as important as him, but she needs a real friend like Yang, but he also knows that she loves him.

"And you are my hero, Dr. Grey. You survived more than anybody I ever knew and life keeps throwing all this crap at and still, you are not giving up. That´s pretty hero- like."

"You don´t have to get all mushy and gooey, Derek. Anyway, thanks for thinking like that." Meredith said.

Derek laughed and kissed her on her cheek.

"I want a real kiss." Meredith fake- complained. Without another word, Derek kissed her and she returned the kiss. They were interrupted from Cristina, who was standing there, looking at the scene she saw. "You are supposed to be resting, you know. Resting ..." She stressed the word ´resting´ with an eye roll. "Come on, Cristina. Don´t be like that. I am getting a pacemaker and I need some distraction and his kisses are really great when it Comes to that."

"Oh, come on, Mer. Please tell me that is not that what I heard." Derek groaned and buried his head in his hands.

Cristina laughed.

"Really, Meredith? Kissing with McDreamy in Cardiac Intensive Care Unit. Now, get up, McDreamy. I wanna spend some time with Mer."

Now Cristina starts kicking him out of CICU. Nah, that is just great. And she calls him McDreamy to his face. This girl´s just ... unbelievable. "Derek?" Meredith looked at him with those puppy dog eyes. "Fine. I´ll go grab a coffee with Mark. Shall I bring something for you from home. Like clothes?" He asked defeated.

"That would be nice, Derbear." She mocked him.

Derek groaned again. She did not call him that in front of Cristina! But she did.

* * *

_**A/N: Thank you for reading and for your support. Please leave a review, it is greatly appreciated. **_

**_Toxic Shock Syndrome_ _is a severe disease that involves fever, shock, and problems with the function of several organs. Toxic Shock Syndrome (TSS) _** **_is a toxin-mediated acute life-threatening illness, usually precipitated by infection with either Staphylococcus aureus or group A Streptococcus (GAS), also called Streptococcus pyogenes. It is characterized by high fever, rash, hypotension, multiorgan failure (involving at least 3 or more organ systems), and desquamation, typically of the palms and soles, 1-2 weeks after the onset of acute illness. The clinical syndrome can also include severe myalgia, vomiting, diarrhea, headache, and nonfocal neurologic abnormalities. _**

**_Migraines can cause intense throbbing or a pulsing sensation in one area of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and Sound._**

**_Now, I will explain White-Bland-Garland-Syndrome. Maybe a few of will remember this condition from Grey´s Anatomy Season 6 Episode 9, where Dr. Teddy Altman first appeared on the Show and where she let Cristina do the procedure under her supervision. Maybe you will remember it, maybe not. Anyway, it means the left coronary artery arises from the pulmonary trunk and not like normally from the Aorta. It is a rare but serious congenital anomaly and normally an isolated cardiac anomaly, meaning it occurs without other cardiac anomalies. With sufficient collateralization the children can be asymptomatic a long time._**

**_Takeuchi- Operation, Tashiro- Operation and the other mentioned surgical procedures are procedures to correct this condition or to normalize the situation, though it might not be anatomical repair._**

**_I know you are probably busy with Christmas-related thingies, but still, as every author I love reviews ..._**

**_Anyway, Merry Christmas ... God Jul ..._**


	15. Chapter 15

**Chapter 15**

* * *

**Every cell in the human body regenerates on average every seven years. Like snakes, in our own way we shed our skin. Biologically we are brand new people. We may look the same, we probably do, the change isn't visible at least not in most of us, but we are all changed completely forever. When we say things like "People don't change" it drives scientists crazy. Because change is literally the only constant in all of science. Energy, matter, it's always changing. Morphing. Merging. Growing. Dying. It's the way people try not to change that's unnatural. The way we cling to what things were instead of letting them be what they are. The way we cling to old memories instead of forming new ones. The way we insist on believing, despite every scientific indication, that anything in this lifetime is permanent. Change is constant. How we experience change, that's up to us. It can feel like death, or it can feel like a second chance at life. If we open our fingers, loosen our grips, go with it, it can feel like pure adrenaline. Like at any moment we can have another chance at life. Like at any moment, we can be born all over again. **Meredith Grey; With You I'm Born Again

* * *

"Derbear." Cristina repeated cackling, she was clearly amused. She was almost laughing. Meredith chuckled too when she saw Derek's embarrassed face expression. That was worth. His face was worth it. She could still picture the horrific expression on his face when she called him like that. "I am going." Derek interrupted them, a look of horror on his face. Meredith called him Derbear in his face in front of Cristina. "Sorry for that. I love you." She mouthed towards Derek who just wanted to wanted to disappear. "Bye, Derek." Cristina waved at him, an expression of hilarity on her face. Derek fled out of the room. Outside, he met Dr. Bailey. "What's wrong with you?" She stopped him as he ran blindly past her. "And what is wrong with your face, why are you looking like you are about to go crazy?" She added with a scolding voice. Derek looked like a little kid that's being chastised. "You don't wanna know. Hilarity issues." "I beg your pardon?" Bailey looked at him with a frown. Derek breathed in, ran his hand through his hair that was so perfectly styled.

"The twisted sisters. Cristina kicked me out for some freak-out time with Mer. Arrgh, I have to go. I have to go, these two are ... I can't stand them together, they " He answered and hurried away. "Hm." Dr. Bailey watched the neurosurgeon running away from the CICU, clearly something happened in there that did not involve any medical issues, more than personal things ... She rolled her eyes. Occasionally she would confront him about what happened in there, maybe it was funny.

Derek saw Mark talking to the chief about a patient or something. He did not care, he just wanted to talk to his brother. "Mark." He said. "What´s up, Shep." He asked, while eyeing him. "And don´t Forget it." The Chief warned the plastic surgeon before he left. "What was that all about?" Derek couldn´t help but ask. "It doesn´t have to concern you, you have other, more ímportant things to worry about. Ah, speaking of important, how´s Meredith?" He asked.

"Considering all the facts, she is doing just fine." Derek answered.

"What happened?" Mark asked. "I just heard she collapsed and that she´s laying in Cardiac Intensive Care Unit. How do you end up in CICU anyway?"

"She crashed and then had a migraine attack. That´s why." Derek answered. "And now she´s in there with Cristina and driving me crazy. She called me Derbear in the face. In front of Cristina Yang." "Who called you Derbear to you face, Derbear?" A voice behind him said. It sounded exactly like Addison.

"Really, Montgomery, you called him Derbear? Where´s your sense for self-control. We are in a freaking Hospital. Behave like it, even if you are acting childish sometimes." Dr. Miranda Bailey scolded them. Derek groaned and buried his head in his Hands. This day is freaking horrific. Mark chuckled, but shut up after Bailey silenced him with a glare. Bailey grinned, they really had respect for her.

"Yeah, have some self-respect, man." Mark said towards Addison, who rolled her eyes. She asked Derek: "How come I have your intern today? Is it too much for you to teach your interns that aren´t Meredith?" "Oh, haven´t you heard, Addie?" Mark interjected, almost smirking. "Haven´t I heard what?" Addison asked back, obviously she didn´t knew anything. "Grey collapsed. She´s in Cardiac ICU as we speak. Apparently Derek was there and fled, because he couldn´t handle the whole ´Twisted sisters having Freak-out time- time´- thing."

"Could we just stop talking about it? It is none of your business, Addison and Mark shut the freaking hell up or I'll beat you to pulp with my not so ineffectual fists. They're quite effectual if you ask me. I came here to talk to Mark ..." he threathened. Soon he would lose his patience with his now again best friend and ex wife. Addison took a step back from him and held up some patient files. "I need to give them to a nurse." Why did she told them that information? It was certainly not, definitely not neccessary. Mark smirked and looked at Derek who wasn't very happy about his current situation. Mark knew he should probably back down, but he couldn't stop smirking like an idiot. Complete idiot.

"In public. That says a lot about you, brainless brain surgeon." Dr. Bailey scolded the neurosurgeon. "Men and their stupidity ..." She muttered to herself. Derek couldn't believe it. Today the world doesn't stop throwing all these weird situations at him and he hated that. The whole world seemed to mock him or worse, the whole world has federalized against him. But the others thought some particular situations were pretty humorous. Like this situation. But it wasn't very humorous to him, more to the others. They were laughing about him and his weird situations he got dropped into. Addison laughed, Mark joined her. "That's no laughing matter." Derek tried to stop them but he didn't make a difference. They were still amused by this particular situation. But there is nothing amusing about somebody lying in Cardiac Intensive Care Unit.

"She coded." Mark said, a firm expression covering his face. "When she was called to the chief's office she coded."

"She flatlined in front of the chief? Wow." Addison said. "It's not like she chose to flatline in front of the chief. It wasn't her freaking fault. She didn't do anything. It's her heart. That's all. And it as sure as hell doesn't have to concern you since your not her doctor. That is Burke and then there are Bailey and Cristina. That are the one that ..." He broke off. Worry about Meredith could be seen in his eyes. Dr. Bailey was watching the three attendings, in case Derek loses his temper and they start throwing punches at each other. "Mark, I told you to keep your mouth shut. Why aren't you listening. Meredith lying in CICU isn't something to joke about." He growled, anger flared up in him like a volcano. "He is right about that one." Bailey interrupted the discussion between the three attendings. They were supposed to act like attendings but right now they didn't. They behaved like interns in their first months working in a hospital.

"So what do you think about working?" She emphasized the word ´working´. "From what I heard, Montgomery, you have a patient with ... Okay, wait. How about we talk about that someplace else." She eyed Mark Sloan and Derek. "It has something to do with ... right. I mean the patients name is Grey too- that is what you wanna talk about." Addison assumed.

The two women ignored both men, who were listening to their conversation. "Wait, Meredith has siblings? And she did not tell me?" Derek wasn´t so pleased when he heard that. "Did you them about Nancy-pants,who can be quite, well, not that easy getting to know. And with Meredith, who isn´t in good condition right now ... Your other sister aren´t that bitchy. But Nancy is." "Oh, Mark, don´t start telling me about my sisters- god, you´re right. I should really call Mum and tell her not to send any of my sister half across the country only to scare Meredith to hell."

Mark laughed. "Have fun with that, Shep. She might as well flee when she hears that you have so many sisters. She isn´t the type girl who does well with family." "Thanks for reminding me, Mark." Derek said, suddenly worried how she will react to that information.

* * *

"That was mean." Meredith scolded her person as she watched Derek fleeing from her room accompanied from Cristina´s laughters. "But it was funny in some way." Cristina countered, still laughing. "It was. But that´s not the reason your here." Meredith said noting the look in her friend's eyes. "They know, right?" She simply stated. It wasn't a question, it was just a simple remark. Nothing more than a simple remark. Cristina looked to the side, staring at the wall for just a while. She avoided Meredith's gaze. Meredith said: "It's okay. They would have found out at some point, why not now." She paused. She looked over to her friend who seemingly wanted to disappear in this very second. Cristina looked to the ground, abashed. "I am sorry for telling them. But I had no choice." She said subdued.

"You are talking about when you told Webber and Bailey, right?" Meredith wanted to know for sure she knew about what situation her friend was talking. Cristina nodded. And continued silently: "I have refused to say anything, I kept saying shoulderstand They talk to you. But they, they did not listen ... tried to persuade me with surgeries, still, I kept saying no to them, but in the end I did not have a choice. I tried to ... " She stared at the ground, ashamed of herself.

For a few seconds nobody said anything. It was perfectly quiet in the room. But there was no tension between the two, they just sait there in complete silence, only the heart monitor beeped in regular intervals.

Then Meredith reached for Cristina's Hand and squeezed it.

That caused Cristina to look up into Meredith's eyes. "I would have never done it if they did not ..." She said, trying to explain.

"I know, I know. You had no choice, so stop blaming you. This is so not Cristina - like."

"This place's changed me. _**You **_changed me, Meredith. Before I came here, I was cold, I was like a machine, did not care about anyone but me and I would have gone to the Chief of Surgery the minute you told me. But I did not. This place has changed me, for good." Cristina suddenly confessed. Cristina Yang never talked very much about feelings. And know she did. "You have changed, Cristina Yang." Meredith confirmed smiling. "Come here." She made place so Cristina can lay next to her as if they were at home. In Meredith's bed and Cristina had just kicked McDreamy out of bed for some freakout - time. Except they weren't at home, they were at the hospital, in Cardiac Intensive Care Unit because one of them needed open heart surgery.

Silence. Nobody said anything.

"How did they react?" Meredith interrupted the quiet between them.

Without turning her head, Cristina answered: "Well, Izzie was pretty freaked about finding out that you never said anything ... ou know, she slammed me against the lockers like you did with Alex." She chuckled when she thought back.

"No, she didn't." Meredith laughed.

"She did."

"No way. I can't believe Izzie does something like that."

"But I knew it." Cristina replied, thinking back. "You know, when all of those patients died before rounds and the whole juju - thing happened, remember? Denny needed a surgery and Burke thought his patient had died because he did not wear his personal scrub cab. Since I had one of his in my locker, I used it to get George out of my apartment." "You mean, Burke's apartment ..." "I failed, you know because of Izzie who was determined to get it back. The reason was that he was about to operate on Denny ..." Cristina told her. Meredith listened to Cristina talking. At least something was like it used to be before the whole thing happened.

"She threathened me if I didn't give him that scrub cap she would fight for it, 'cause she knew How to kick my stupid Beverly- Hills- Ass ... it was quite funny actually though she did not slam me against lockers back then ... But she threathened to do that exact thing to me ... and funny, yet she did it." Meredith laughed. "She really called you that? Here you go, Izzie Stevens."

"You're laughing? Wait, Mer, that isn't fair." Cristina protested. "Life is never fair. You should know that by now." Meredith countered, chuckling. Cristina stopped laughing, she looked thoughful as if she was thinking about something what is very important for her. Suddenly Cristina got serious again. "Cristina, what is going on, you look like you want to say something or you worry about something. "It is just that I never had such a good friend like you are to me. I call you my person, my twisted sister ... You know me better than I do. I never had anything like that before." Cristina explained quietly.

"Now my person is about to undergo major cardiac surgery with all possible complications. I can´t stand the thought to loose you. I already lost my father in a car accident when I was nine years old. Now, if I lose you too ..." She trailed off.

"You won't loose me." Meredith replied, she tried to convince her. "I won't die."

"You don't know that with your previous history ..." Cristina was all dark and twisty now.

A single tear escaped from her eye.

"Come here, Cristina. I am your person, you are my person." She started to say, then continued: "I will still be your person even if I die - which I hopefully won't. And I will try to stay out of the light, 'cause I would have to leave you and Derek here. If I died ... That you won´t survive and he would never be happy again, so I won't, for sure as hell won't die."

"Thank you." Cristina whispered.

"You are my person."

"And you are mine."

* * *

Izzie Stevens was sitting in the Cafeteria and ate her meal and she kind of was wondering where everybody else was. Meredith could not be here, that was as clear as it could be considering the fact that she was lying in Cardiac Intensive Care Unit. Meredith had lied. To all of them. Only Cristina knew. Cristina, of all people. She was still shocked about that nobody, that no one thought it was necessary and important for her to know about Meredith having a heart defect and that she'll need open heart surgery ... "What did she think she was doing? I think we deserve to know what happened." She uttered to herself.

Izzie got upset, mumbling all these things to herself but George heard what she was saying and because of that he was confused. At first she did not show what she feels, mostly, of course, it was shock ... And hurt feelings that resulted from leaving her in the dark. Izzie was angry at Meredith. Why did she do that? What meant their friendship to her? She had trusted her that she was being honest. But now, right now in this moment, she knew Meredith Grey hadn't been honest. She purposely withheld information that was important to know. And that couldn't be excused. They were roommates, freaking roommates. You tell things like that your friends.

Then, after some time to think, there were other feelings too, not to mention the the anger and hurt that she did not say anything. Everything was repeating itself. Everything that happened to Denny ... Meredith experienced almost the same, but as a child ... She has had open heart surgery when she was an Infant ... What did Mer feel when she watched that? She knew what medication to use to stop his arrhythmias ... How could we not notice the signs? Wait, the echo - thing. Cristina echoed Meredith's heart back then and she interrupted them ... Why didn't she do anything? Like blackmailing? She could have gone to Bailey ... Why didn't she think of that?

Izzie shook her head.

She still couldn't believe it.

George O'Malley was sitting at her table too. Cristina was somewhere else, maybe she was sitting in the gallery and watch random surgeons perform random surgeries or more possible she was visiting Meredith. "Iz ..." George was talking to her. "What ..." Izzie was not focused, she did not seem to notice that George talked with her. Or to her. "Izzie." He repeated somewhat worriedly. "What's wrong?" He wanted to know, his fork hanging in the air. "What the hell is going on with you, why are you so angry?" He tried to get information out of her but Izzie was stubborn and told him that she won't tell him. At least not now. "No, George, I can't tell you right now. I am too angry to do so." She told firmly and started eating her salad. George continued to watch his friend closely, his gut told him there was something that matters, something from importance. He shrugged and fakes eating his meal.

"Where are they?" He asked, his mouth full. With they, he meant Meredith, Cristina and Alex, their intern colleagues.

"Not here." Izzie answered shortly, staring at the table.

"Izzie Stevens, just tell me what's wrong?" He demanded to know. "You want to know? George, if I tell you you, are going to feel hurt just like I did. And still, it hurts that she never ... never said anything to us when we lived in one house, practically ..." She couldn't find the right words to express what she wanted to say. "This is about Meredith, am I right when I assume this?" George asked, trying to make sense of Izzie's weird choice of words. Of course it is, you idiot, what do you think it is about, she answered him in thoughts but not loudly.

"Yes, it is. Who else do you think this could be about, hm?" Izzie gave back sharply, running her finger through her hair, obviously nervous. George flinched. Izzie was acting barely like that. She was all perky and shiny and is always in agood mood. But today, she was different. She seemed unnaturally tense, as if something was going on. "I ... I don't have a clue. Not a single one. Just tell me. I am not breaking. I accepted that she's with McDreamy, ugh, Shepherd ..." George stammered. "There, you said it. Heya, George." Izzie interrupted him, switching the topic and obviously avoiding the topic that is much more important. "Stop it. I hate this McName - calling." George said. "You just did it yourself." Izzie answered, half laughing. "I did not ... " He protested without having a single chance. "You so did. Get over it."

"So, what's going on with Grey, now that we've established that she's lying in Cardiac Intensive Care Unit?" George pressed for mor information. But Izzie didn't have much that information. It was very limited. She only had the bits and pieces she got from Cristina, who didn't like the fact that she knows very much.

"She was born with a heart condition." Izzie told him. George almost choked when he heard those words.

_Congenital heart defect? Meredith was born with a heart defect? This was some kind of joke, right?_ He thought to himself. Meredith Grey, daughter of the infamous Ellis Grey, was born with a freaking heart condition? Whoah, he didn't expect that, he so didn't expect that. Now he was shocked. He never thought that she was sick. She was like any other intern. But then he thought back to the last months. Meredith had changed. She was always at home when she wasn't at the hospital. She seemed tired every day but he blamed it on the internship that stressed her out, he had never even thought about this possibility. Then, he remembered another thing: She wasn't as physically fit as she was when she began her internship ...

But he understood why Meredith didn't want to tell Izzie. Izzie talks very much and there is a pretty high risk that she will tell someone here, why obviously doesn't matter anymore since Meredith collapsed. So why didn't he notice. Then a loud voice interrupted his thoughts and he snapped back to reality. He noticed Alex was here.

"Who was born with a CHD? Anybody I know? Or is it a peds patient. Anybody know why I am suddenly on Gynie Squad again when I should have been on neuro today?" Alex's voice was heard by Izzie and George who simultaneously looked at Alex. Alex weighed oneself down. He quickly let himself fall on a chair. Then he put the tablet with a loud bang on the cafeteria table, so that some doctors and nurses at the neighboring tables looked up startled. Izzie looked at him disapprovingly. "So, why can't you do that a bit louder?" She asked. "These people back there haven't heard you." She said as a pointed remark. Alex rolled his eyes and ignored the blonde doctor.

That was an insensitive Alex. He was in the dark about what happened to one of them but still ... He really could show some empathy. Meredith was one of them ... Even if she had lied to them all.

He really could show some empathy ... but she knows evil spawn lacked at showing empathy or feelings towards another human being but Izzie still worked on that, trying to make Alex to a better person because deep down he is good person - he just needs to show what a good man he is ... God, she should probably stop becoming all warm and mushy.

"What's up?" He asked, as the nagging silence got to him. Neither George nor Izzie were saying anything, they were just watching him. He shifted uncomfortably. Why were they acting like that, he wondered silently.

"You could show at least some empathy for your colleagues and friends ... Oh, I forgot you don´t know what friends are." She mocked him. Alex hated when she did that. As if he didn't know what friends are, but did she know what friends are? Did she? That was the question. Alex lifted defensively his Hands. "What did I do now?" He asked. "I just came here to eat my meal in peace. But you guys, ah, forget it ... You're a hopeless case. Just forget about it, it isn't that important." He said resignedly and began to eat. Silence. Izzie was mute and so was George.

After a while, he asked: "What was that about congenital heart defects? You were talking about that." He was interesting in pediatrics. At first, he thought plastic surgery was interesting but all this dust- dry coffee and muffins he had to buy for Sloan weren't that interesting. Pediatric surgery was way more interesting. He liked working with little humans. Peds surgeons are hardcore and he wanted to be hardcore. Then Izzie answered. But when Alex heard her answering, he was sure his heart stopped for a second. "I kind of was talking about Meredith." Izzie suddenly said. Promptly, he remembered that weird encounter with Meredith, Shepherd and Yang.

Within seconds she got the attention from both of them.

"Meredith?" George asked perplexed. "You were talking about Meredith, as in Meredith Grey, who is Ellis's daughter and who we live with?" "Yeah, I am talking about Meredith Grey, daughter from Ellis the one with live with. I think that should answer your questions, George." "It does. With unbelievably full clarity." He looked at her, obviously he couldn´t believe what he was hearing. Alex looked up from his meal. "Does anybody know why I am suddenly on Montgomery's Service again instead of being with Shepherd on his cases and assisting his OR?" Alex asked again. This time Izzie answered.

Izzie nodded. "I think I know why." She then said. "Why then?" Alex asked back. "It's all about Meredith. Shepherd and she are together, so that means ..." She trailed off, she didn't complete her sentence which made Alex annoyed. "I know they're together, I may be an ass but I am for sure as hell not blind." Alex interjected sharply, he was sick to death of Izzie's behavior. "I wasn't so sure about that ever you slept with that Syph nurse instead of me." Izzie still couldn't let it go. "Izzie, shut up. It's just Alex." George tried to stop the blonde doctor. "I mean, I am real good in bed. But you slept with Olivia instead of me." Izzie spat. Alex didn't say anything.

"God, Izzie, just let it go." George groaned.

"Let's continue that conversation about Meredith being born with a heart defect." George almost pleaded, he couldn't stand Izzie's behavior any longer. She was like a real pain in the ass when she behaved like that. It was in the freaking past and she should leave it with that. "How did you find out?" George asked, trying desperately to change the topic. It worked. Yay for Georgie. "Partly, you were with me ... But then I confronted Cristina who wasn't very pleased about me asking, but I kept asking her and she told me about Meredith being born with a congenital heart defect." Izzie told her intern colleagues. "I bet you didn't just ask her, you harassed her. I have my sources." Alex laughed when he saw Izzie's face expression.

Silence. Nobody said anything.

Then Alex asked with a somber expression that looked somewhat worried: "Poor Grey. Do you know what kind of heart defect it is?"

Izzie shook her head. No, she didn't have an idea. Why the heck didn't she ask Cristina when she had the chance. But know she didn't know so she just shrugged. "I don't know what kind of defect she has." Izzie stumbled over the words and Alex nodded knowingly. Of course she didn't knew, why should she?

Then he took a deep breath and started making some things clear: "Well, because there are all kinds of heart defects a baby can be born with. Circa 40.000 children with CHD are born in the US per year. The defects can be quite simple and easy to correct if neccessary, but most defects are quite complex, if not highly complex." He explained to the others. "Hopefully, hers wasn't that complex. the more complex a heart defect is the difficult it is to correct it or there are higher risks of post- operative complications or latter medical concerns like arrhythmias ..." He stopped and then: "Some defects can't be repaired, they can't treat these babies with palliative surgery but ... that is causing an adverse effect of the health - related quality of life ..." He didn't complete the sentence.

"How do you know that?" Izzie asked seemingly interested.

"Spent some time in the Vagina Squad, therefore I had to deal with sick babies every day, some of them were born with heart defects. That is how I know. Surprised, huh?" Alex grinned and leaned back into his chair. "You bet." Izzie mumbled.

* * *

Meredith looked around in her room and sighed. Cristina was gone, charting or something else and nobody was visiting her, even though they supposedly already knew. She paged Cristina on her pager. "What's going on. Are you okay?" Cristina wheezed when she came running into her room in Cardiac Intensive Care Unit. She gasped for air- "Are you okay? Is something wrong, can you breathe? Should I page Burke?" "I am bored. I am laying here for the next weeks or days, whatever, I _will _die. Because of boredom." Meredith complained. Cristina looked at her as if she had lost her mind? "I will die. Because of boredom." She said for another time.

She emphasized the word will. Cristina looked at her thunderstruck. She couldn't be serious, could she? She did not page her, because she was bored. _Bored. She paged her because she was bored, hello? Find the mistake._ "Really, Meredith, you didn't page me because you're bored and want to be entertained? God, I could be missing surgeries. Surgeries." Cristina exclaimed. "Derek's doing a craniotomy at this moment, I believe. "Now that's the Cristina I know and love. As a sister, you know. Are you back to normal?" Cristina just scoffed. "Please, just take me to the gallery or the cafeteria, somewhere with people to watch." Meredith pleaded. Cristina seemed to consider it.

Meredith looked at her with big, blue puppydog eyes and the surprising thing was that it seemed to work. "Bailey will totally kill me." Cristina muttered under her breath. She helped Meredith sitting up and organized a wheelchair and a portable monitor to monitor her heartbeat. Meredith chuckled. "She'll kill me too for being that uncooperative." "Fine, Bailey will kill us both."Cristina muttered. "Oh, come on, this is going to be fun."

"For you, yes." Cristina gave back. "Bailey will make my life a living hell when she catches us."

Cristina wasn´t sure if this was a good idea, but Meredith was her person and she was totally capable of doing CPR on someone if neccessary. Except the fact that she freezed when Meredith collapsed in front of her, Bailey and the Chief. When Meredith was finally sitting in the wheelchair, the portable monitor on her knees, Cristina stole a patient from Cardiac Intensive Care Unit and wasn´t feeling very good about that ...

"Where should I wheel you?" Cristina asked. "Maybe the gallery? But there are sitting other physicians watching a surgery, maybe Dr. Bailey or somebody else who is in charge of us." Meredith thought loudly. "What about the cafeteria? Too full with people. I wanna go to the freaking gallery. I need to see someone cut, even if I can't right now."She explained. Cristina tried to do her best in holding a laughter back. "What's up? Why are you laughing?" Meredith demanded to know.

"Surgical junkie." Cristina grinned at her best friend.

"As if you weren't, too." Meredith countered.

"I am a surgical junkie, yes, and I absolutely love it." Cristina said in a funny, Cristina - like way and almost laughing. Meredith joined her. "Now, let's go to the gallery. See, if we get a seat." Meredith rolled her eyes. "I don't need one, I already have one." Meredith pointed out the obvious. "You are sitting in a freaking wheelie, Mer. A wheelchair." "So?" Meredith asked back. "I am a patient." "Who should be under constant supervision from her resident, the intern on the case, the nurses and all the other doctors in case, this special patient decides to code again." Cristina told her.

"Ass." Meredith said inaudibly.

"I heard that." "Fine." Meredith crossed her arms over her chest. Cristina hides her grin.

When they were there, they could see that Derek Shepherd performed a surgery to save a man, obviously he was in some sort of crash with a car maybe that caused this injury, who had a frontobasal injury. Derek was highly concentrated while he was working on a man´s skull together with plastic surgeon Mark Sloan. Both were overly focused on their patient, which was good for the patient ... But they did not see that a small frame was sitting in the gallery, watching them operate even if she should be in Cardiac ICU right now.

"Wow." Meredith mouthed, while she watched the surgeons work hand in hand to save this patient´s life. Cristina wasn´t paying that much attention to the surgery, she had some charting to do. If she didn't catch up on that, Bailey would kill her doubled. For this, for taking Meredith to the gallery and sneaking her out of the Intensive Care Unit and for not completing the charts. "Cristina, look." Cristina got pulled to the reality. Where she was sitting in the gallery with her person and the disturbing beeping of Meredth's portable monitor. Meredith pointed at Derek Shepherd, who was currently cauterizing a brain bleed.

And causing Meredith to freak out. "I see McDreamy cauterizing a bleed. Wow." Cristina made fun of her friend. Meredith rolled her eyes, then focused back on the surgery. "Good, this is so much better than lying in a hospital bed all day. God, I miss surgery right now, how am I gonna survive the next few weeks, Cristina. Tell me." Meredith looked frustrated when she thought about that.

Cristina made a faint sound that sounded like a 'Hm. Stop disturbing me with your little problems when you should be in CICU right now'. Meredith rolled her eyes and soon her gaze wandered across the room to the monitor where she could see what was happening. She wanted to be down there. With Derek, holding that scalpel, watching Derek making precise moves with the surgical instruments, looking up to her and a stolen smile ... that was all she needed for the world to be perfect. Also, not being born with a congenital heart defect would have been nice. But you can't have all and sometimes the things you have are enough - at least right now, in this specific moment.

* * *

_**A/N: Here is the new chapter, the last one before year 2015. Happy new year for all of you ...  
**_

_**So, Meredith's in Neuro-glow, even though she should be in her room in Cardiac Intensive Care Unit. Will they discover that their patient isn't there anymore or will they just miss it? Stay tuned for finding it out ...**_

_**Frontobasal injury or frontobasal fracture is a fracture, in which parts of the anterior skull base are fractured. Frontobasal fractures occur mainly in the context of workplace accidents and traffic accidents. The thereby applied to the base of the skull forces lead to a fracture of the anterior part of the skull base (ethmoid roof, posterior wall of the frontal sinus, roof of the orbit, the sphenoid sinus and nasal cavity).**_

_**Frontobasal fractures cause a hematoma or a monocle hematoma and subconjunctival hematoma (Hyposphagma). Furthermore, bleeding is observed from the mouth and nose as well as demolition of the Fila olfactory anosmia. Often you will find simultaneously lacerations on the forehead and a concussion or a cerebral contusion. Fractures in the region of the transition from the ethmoid sinus often lead to rupture of the dura mater with Rhinoliquorrhoe which pantoscopic angle by a head and compression of the jugular veins internae is enhanced. Often there is also a Pneumatozephalus can be observed. **_

_**If the internal carotid artery is injured in the region of the cavernous sinus, a pulsating exophthalmos and nosebleeds can be observed. In a frontobasal fracture, there is also the risk of intracranial hemorrhage optic and the lesion of the nerve. **_**_Treatment consists of surgical treatment of fractures with reduction and internal fixation of the fracture fragments. Associated injuries (such as of the Dura) should also be treated surgically._**

**_I really hope you liked it. Let me know and leave a review please ..._**


	16. Chapter 16

**Chapter 16**

* * *

**Over the past twenty years, one of the most valuable tools a doctor has is the algorithm. Your patient's main complaint goes into a box and then the formula helps you to decide what to do next. But what happens when the problem doesn't fit into a box? Well, you're suddenly on your own. Unexpectedly, with about a thousand paths to choose from. So what do you do? How do you decide when you're left in the dark? How do you make sure you're not making the worst mistake of someone's life? You close your eyes. You block out everyone and everything around you and you pray that the voice inside you is right. Because once you've decided, you can't ever go back. **Change of Heart; Meredith Grey

* * *

"Honestly, Cristina, tell me How I am gonna survive without being in an OR for the next time." Meredith grumbled, already missing being in an OR. "You´ll be in an OR sometimes, Mer." Cristina retorted without looking up, she just continued scribbling something in an unreadable writing in a patient chart. "As a patient." "So, still you´ll be in the OR." "It is not the same." Meredith tried to tell her, but Cristina laughed. "I know I should be in CICU. But I don´t wanna be there. I want to be here, watching Derek save a life." Meredith said, looking through the glass of window that separated the Gallery from the operating room.

"Well, like I said if Bailey catches us, we are dead. We are so so dead, both of us." Cristina said, raised her voice unnaturally high.

"You already told me that. Why don´t you get yourself a coffee or something like that so you relax more." Meredith suggested.

"And leave you here, all by yourself?" She scrunched her nose. "Uhuh, I am not gonna do that. Not happening. For sure as hell I am not going to leave you here. No, Mer. Sneaking you out CICU is one thing, but not looking after you when you are at risk for coding is the absolute opposite of being responsive. I am wondering why Derek hasn´t seen you sitting in the freakin' gallery." "Just get your freaking coffee. You are overtired and stressed and I need you to be attentive when you are scrubbing in on my EP study. Otherwise you are not." Meredith told her friend.

"Oh, god, you´re so mean and you definitely want an intern who isn't as good as me, 'cause I am Cristina Yang. Best cardio fellow the world has ever seen." "You´re an intern. There are years between you being a cardiothoracic surgery fellow and now. Don´t get ahead of yourself." "You´re no fun." "Would you be fun when you about to get a pacemaker, and Uhh, on top of that, as the icing on the freaking cake your aortic valve needs to be replaced?" Meredith looked at her person, waiting for her to answer. "I guess I wouldn´t be that much fun then in that specific situation." Cristina answered tentatively. "Oh, I forgot the surgeries I needed as a kid, you know." Meredith continued. "Just go on. I´ll sit here." She made a protruding gesture through the room and then she Finally began to redo her patient charts, some of them were sloppy. Then her pager shrieked. "Oh, no." Cristina muttered indistinctly.

"Who is it?" Meredith asked alarmed. "Is it Bailey?" She urged, suddenly she was fully alert. Cristina looked up from her pager.

"Is it Bailey? Has she discovered that I am gone, disappeared from Cardiac Intensive Care Unit?" "Yes, it is." Cristina said, having a serious expression all over her face. "Crap. Crap. Crap." Meredith' face fell, she was terrified of Bailey finding out. She already collapsed in front of the Chief and couldn´t afford another misstep ... "Is ´I told you so´ inappropriate?" Cristina wanted to know. Meredith didn´t answer, panic showed up on her face. "Hah, joke." Cristina laughed. Meredith glared at her. "Are you crazy to scare me like that?" She was startled when Cristina told her it was a joke. That it hadn´t been Bailey that paged Cristina. "Are you crazy?" She repeated, has difficulty to recover from her shock. Her heart rate accelerated, but went down to a normal range after maybe one minute.

"Relax, Mer. She didn´t find out. Not now, anyway."

"You know what Izzie can babysit you, she knows how to use a crash cart in case something happens, what I don´t hope." "Nice." Meredith replied as she rolled her eyes. "Drama queen will be babysitting me. That is just perfect ..." Cristina grabbed her pen and the patient charts, but then she accidently dropped one of those heavy Charts. Everything was falling to the ground and caused a total mess.

Meredith chuckled quietly, making sure Cristina wouldn´t hear. "Don´t think I cannot hear you. I can hear you perfectly. So better shut up." Cristina ranted while cleaning up the mess she made. "Damn mess, damn Charts." She mumbled to herself. Meredith just watched her person. When Cristina was finished cleaning up her mess, she said: "I need coffee." With that she left the room. Meredith did not follow her and did not made a Sound. Then Izzie was entering the Gallery. Meredith rolled her eyes, knowing that she had to face Izzie.

"Did you page her?" Meredith asked coldly. "What, you mean I paged Izzie? Yeah, I did."

Meredith shot her a glare. If glares could kill, Cristina Yang would have been dead by now. "Okay, I gotta go get my coffee. Oh, and Mer, don´t try to pull anything funny."

"Like what?" "Maybe coding or anything that qualifies as a possible code. Don´t try and sneak away." Then she turned away, but stopped at the doorstep. "Izzie, don´t let her disconnect the leads to the portable monitor. She is at risk for going into arrhythmia." She gave advice Izzie shouldn´t be turning down. "I´ll be right back." Then she left to go get her coffee and some snacks for herself and maybe Izzie from the vending machine. Meredith should not eat before the procedure and Cristina is watching over her like a hawk.

"Why didn´t you tell us? We are your friends?" Izzie sounded hurt.

Meredith didn´t respond to that. She knew the questions would come soon enough but not now. "I didn´t want anybody to know." She finally answered dejectedly. "Cristina knew." Izzie said coldly. Meredith lowered her gaze, then told her that Cristina and she had a Special bond and that Cristina was her person. "So what, we are just roommates, is that what we are? I thought I knew you, I really thought ..." She stopped. "But then the thing with your mother happened and I had doubts but told myself it was just that little Detail. But it wasn´t. I ... really expected you to be forthright with your health. But you are hopeless case ... So I just hope Cristina will be here soon, so I can get away from here." Izzie looked at Meredith.

"Izzie." Meredith said. "No, you know what. Just stop. I don´t want to hear excuses again. I have trusted you. But now?" She scoffed. "You don´t let me explain. I was there with you when you decided to cut the LVAD wire. I understand why you did it. I know what it is like to live in a Hospital for months, surgeries, heart catheters- I know all of it. You didn´t know what Denny felt. The fear of dying, leaving loved ones ... It is unbelievably painful and it never ends."

"Don´t talk to me about Denny. You don´t know anything." Izzie hissed.

"Maybe I don´t but that is not the Point, the point is that you won´t listen to me. You don´t give me a Chance to explain why I did not said anything about my heart defect. I know how people react when they hear that. They point and stare. Also, they judge. My ability to be a great surgeon just as my mother. I will be great one day, but people will just see this little detail and nothing else. I was trying to avoid that. Except I failed, 'cause nothing changed. It is kind of dumb to assume things will get better, people forget but some of them will judge. Think about what I said, Izzie." Meredith told the blonde doctor. Izzie didn´t say a word.

Then she concentrated herself and focused on writing patient medical charts. That sounds fun. Meredith looked if nobody saw her. She was focused deeply on completing patient charts, so that she doesn´t noticed that Meredith wasn´t sitting next to her anymore. Meredith made a plan to sneak away, surreptitiously and quietly. Without the wheelchair. There is no way she would go any further with that thing. Then everybody will know she is the patient and they will stare and talk and that she hated. She looked over at Izzie who wasn´t looking.

Meredith escaped when Izzie wasn´t looking. Cristina wasn´t looking too. Okay, she would be looking if she had not been paged. Now she was all alone. With Izzie who stared at her with a creeping gaze that makes her feel uncomfortable.

* * *

"I am one hundred percent surprised, Evilspawn." Izzie laughed. George still stared at his colleague. "You like Kids?" She then asked. "What, no." Alex exclaimed. "I mean, I don´t want to work with them." "Now you are a liar." Izzie told him. "I am not." Alex scoffed. Izzie just watched him. He always told everybody he hates being on Montgomery´s Service, but there he gets to scrub in on real surgeries. "So, back to the topic CHD. What else do we know about it?" Izzie asked aloud. "Like I told you, there are all kinds of heart defects."

"Like what?" Izzie wanted to know. "There are heart defects with constant left-to-right shunt, These defects are not cyanotic, a least not at first. AV Canal Defects, Ventricular Septal Defects, Atrial Septal Defects and patent Ductus arteriosus are heart defects without cyanosis. Then there are heart defects with cyanosis like Tetralogy of Fallot with right-to-left shunt because the pulmonary valve is obstructed. Then there are right heart and left heart obstructions." Alex told them.

"Wow, Alex, why do you know so much about this." "I already told you that. I cannot make you listen to me." Alex laughed at Izzie. "What do you think is her defect?" Alex asked. "I wouldn´t know. Maybe one of the difficult ones- maybe HLHS." Izzie answered. "That would mean her left ventricle is hypoplastic and not able to pump blood through her System." They didn´t notice Dr. Burke standing behind them. He cleared his throat. Izzie flinched when she noticed Dr. Preston Burke overhearing their conversation. "What are you talking about? I heard you said something about Hypoplastic Left Heart Syndrome?" Nobody answered him. "It was about Grey, am I right about that?" He glanced over the table, focusing each intern, his stethoscope hanging around his neck.

"Yes, Sir, you are right." Alex Finally answered. "What the hell are you doing, Alex. You should not have told him what we were talking about." Izzie whispered sounding pissed off.

"What? It´s not like he wouldn´t find out eventually." Alex shrugged.

Izzie rolled her eyes. This was typical Alex.

"He is right. I would have found out anyway." He said, glancing at them. That makes George and Izzie shifting uncomfortably in their seats. Then he continued: "Maybe you should visit her instead of making assumptions that aren´t really true. So just stop talking about it and ask her. If she wants to tell you, she will. If not, she won´t but that is up to her. Don´t have something to do instead of sitting here and talking about someone else´s life?" He looked at them expectantly. "I have to go." Izzie said suddenly when her pager beeped. "Don´t leave me here alone." George whimpered when Izzie was about to leave. You´ll do it. I am sure, Georgie." Izzie told him. Burke waited two seconds before turning to Alex. "Come with me." He told him.

"Why?" Alex inquired suspiciously. "Don´t ask, just come." He told him.

Alex Karev nodded slowly and then followed him. "But I am Burke´s guy." George mouthed. "Now Alex is scrubbing in on the case. Get over it already. Do you think it is Meredith´ case he´ll be scrubbing in on?" "That may be Cristina." George guessed. Izzie scoffed and left. Cristina was paging her to the Gallery, though she didn´t know why Cristina would page her to the gallery ... Maybe it was just one of the many things she did not understood.

* * *

Alex wasn´t sure where they were going. Then he recognized it. Neonatal Intensive Care Unit. So this case is a Baby being born with a heart defect. Cardiac surgery, cool. The heart was an interesting organ ... and it was interesting and it gives quite the rush to operate on so tiny humans like neonates. "Well, Dr. Karev, ready for an open heart surgery?" Surprised, Alex nodded. He did not expect that. "What is it for a surgery?" He asked.

"We're operating on a two-day-old infant performing a procedure called Arterial Switch Surgery." Dr. Burke told him.

"So we correct a transposition of the great vessels, a simple d-TGA without any other cardiac or extra cardiac abnormalities." Alex said, still surprised why he was chosen to scrub in on the surgery as Dr. Burke handed him the medical record. "Tara Lades, was born two days ago, marked cyanosis, unstable status after Rashkind- Balloon atrioseptostomy."

Alex took the medical file. "Hello, I am glad to be joining you today. I am Arizona Robbins, new head of pediatric surgery. Nice to meet you, Dr. Karev. Hello, Dr. Burke, we´ve already met." Arizona greeted Alex, she was perky. It was one of the things Alex noticed first. And she seemed nice.

"Yeah, we did." He answered. Arizona smiled warmly and then turned towards the parents, who were watching their daughter with worried expressions on both of their faces. There were lots of wires, catheters around and the leads of the cardiac monitor. " Prepare little Tara for their operation." Dr. Burke told the young assistant doctor. Alex Karev nodded and went to work. The parents were pretty worried about their daughter having open heart surgery so soon after birth, but Dr. Burke explained them that is was the only option in order for their daughter to survive and have a life. Alex had to explain the procedure twice, but he had no problem with it. Dr. Burke was watching him. After all, the small Tara was ready for her surgery ...

Now the parents had to separate from her sick daughter who but is now being brought into the OR. Dr. Burke would first make a median sternotomy, to gain access to the heart and chest cavity. After they had Tara connected to the heart lung machine, but without circulatory arrest, Dr. Burke went to the perform the closure of the patent ductus arteriosus who she had been dependent on before the heart surgery.

Alex was allowed to hold the clamp. On top of the gallery sat Cristina, who watched him enviously. God, she would really like to be down there right now instead of him. But she really should get going. Meredith was waiting for her to come back. Hopefully Izzie did not screw it up with Meredith. She probably should go back, but this was too interesting to not watch the entire procedure.

She still couldn´t believe it that Meredith used to be that little girl on the operating table.

She sighed.

Arterial switch surgery. She would have liked to scrub in on that surgery, even though she the surgery did not begrudge her friend. Dr. Burke groomed under whereof the pulmonary arteries to the hilum and he severed the great vessels.

Alex watched everything careful, happy to be in this OR and watching Dr. Burke doing the work to save a little girl, so it can have a chance of a normal life...

It was followed by the Anteponierung or Lecompte named the pulmonary artery. Next was the mobilization of the coronary arteries and reimplantation in Neoaorta. Dr. Burke reanatomosed the aorta ascendes and then Alex was allowed to close the ventricular septal defect with a patch under the guidance of Dr. Burke.

"Very well, Dr. Karev." He praised the young surgeon in training, as he had closed the hole in the ventricular septum without complications. He accepted the praise smiling. It was followed by the reconstruction of the pulmonary artery to the pericardium and the readaptation of Neopulmonalis with the right and left pulmonary arteries. Then Dr. Burke let him close up the baby´s chest cavity and rib cage.

"So, we are finished." Dr. Burke told him. That was great work, Dr. Karev." Arizona told him, she watched and assisted Dr. Burke first the whole procedure, making sure everything was going smoothly. She was the pediatric surgeon on the case.

"Well, then ... get her to recovery and then Neonatal Intensive Care Unit. Great work everybody." Dr. Burke was leaving the OR, Arizona Robbins stayed with the child to make sure it is okay. Alex Karev followed the cardiac surgeon to the scrub room.

"Wow. That was amazing." He told him.

"Yeah, it was." Dr. Preston Burke held his hands under water and smiled at the intern, who seemed fascinated by the surgery he just scrubbed in. It wasn´t the heart surgery that was magical for him. Well, it was. But there was another thing about the surgery. He liked the pediatric cases. Izzie was right. He likes working with sick children. He wants to help them. Addison just brought him there. He had always preferred scrubbing in on a C-section than on a plastic surgery where he could do nothing but watching. "Will you come with me? I need to inform the parents." Burke told him.

"Yeah, of course I´ll come with you." Alex replied. He wanted to see the parents faces when he told them that their daughter lived. That she will live a normal life. That they completed the procedure without any complications. "Then come." He told him. The parents of the little girl were sitting in the waiting room, waiting for news, preferable good news. "Mr. and Mrs Lades." Dr. Burke said. Immediately the father stopped pacing along the floor and came nearer. The mother looked worried, hoping for good news. But still, there was fear on their faces, the fear of losing their newborn child.

"So, we have great news." Dr. Burke told them, immediately seeing the relief on their faces. "The surgery was a success. We have successfully switched the arteries and everything went without complications." "Thank God." The mother answered. "Our daughter is alive and okay?" "She is." Alex reassured them. Then both Alex and Dr. Burke were paged.

"Damn it." Dr. Burke said. "This page is about Meredith. Sorry, but we have to go. Out pediatric surgeon on the case will be here in a minute and take you to see your daughter." Then they hurried away to Cardiac Intensive Care Unit, hoping that is was nothing serious. But it was urgent, otherwise they wouldn´t page them with that kind of message.

* * *

"So, you think this patient. Molly Grey is her name, right?" Dr. Bailey asked. Addison Montgomery nodded. "I think we should take a blood sample from both of them and run them in the lab and wait what it says. It doesn´t have to be official. They are both patients here." "No way. We should do this officially. The chief would agree. Would you like me to talk to the patient?" Dr. Bailey asked. "We need to get her consent."

"I´ll do it. She is my patient. Anyway, where is Karev? He is supposed to be on my Service." "I don´t know. I think he is scrubbing in without cardiac surgeon on a peds case. You know the new peds surgeon? I´ve never met her. But from what I heard she is great. She did her residency and pediatric surgery Fellowship at Johns Hopkins Hospital. It has ..." "... the best peds Programme in the Country, I know." Addison cut her off.

"Yeah, so I think she is a good catch for our Hospital. I am just saying. So Let's find Grey, Which won´t be that difficult considering she is lying in CICU." Bailey said. "Yeah." Addison nodded. When they discovered that the room was empty, they were shocked. For some seconds they just stood there and glanced through the whole room. Meredith isn´t here, they also looked in the bathroom, but there was nobody. She was gone. Her ECG leads and electrodes were disconnected, the Monitor was switched off by someone, presumably by Meredith herself.

"Please tell me this is not what I think it is." Dr. Bailey said slowly.

"But it is. As much as we don´t want to admit it, Meredith is not here anymore." Addison said, worry in her voice. "Damn it, this girl´s really escaped. Why did nobody notice?" She took out her pager to page Dr. Cristina Yang, Derek Shepherd, Dr. Preston Burke, the other interns she was friends with and the Chief of Surgery Dr. Richard Webber. Hopefully they will be here soon. The message said that they should come to Cardiac Intensive Care Unit as soon as possible and not a minute later.

"I never thought she was sick." Addison suddenly said. "What?" Bailey responded. "Meredith, I am talking about Meredith Grey who is missing."

"Hm."

"She wasn´t different from anyone of this group despite the fact she slept with my ex-husband. Unknowingly. And I know that I cheated on him first. So Meredith was the innocent victim here, because she did not know he was married. So you don´t need to give me the famous Bailey-look." Addison told her.

"Good, then."

"I never thought she was sick. When she didn´t show up, I just thought she was being irresponsible, though she wasn´t." Addison continued, referring to the situation where she accused Meredith of being not reliable. In front of Dr. Bailey, which was a mistake.

"Maybe she is." Bailey answered. "Where are they? The message said they should come ASAP. Why aren´t they listening?" She grumbled.

* * *

When Cristina returned to the Gallery where Derek finished his surgery, she found Izzie doing patient charts instead of watching Meredith. "Izzie." She said. "Where is Meredith? I just went to get coffee and you´ve lost her?" Cristina was worried. This could not be true. She had trusted Izzie to stay here and watch over Meredith, but apparently it had been too much for her. Izzie looked up startled. "What, wait, what are you talking about ..." She asked confused. "I told you to ..." "... babysit Meredith, I remember." Then Izzie rolled her eyes. Just because ... she doesn´t have the right to barge in and shout at her that she has lost Meredith.

"Where is Meredith, Izzie?" Cristina asked coldly.

"Will you get into Trouble for stealing patients from the CICU and losing them in the hallways?" She teased the Korean doctor. "Stop right there, Izzie. Do I have to remember you who stole the donor heart for Denny? That was you." "Why the hell is everyone talking about Denny? I don´t get it." Izzie wondered out aloud. "Yeah, I lost her. I was writing medical records."

"You know she´s at risk to code?!" Cristina asked Izzie who nodded. "Why didn´t you pay attention to what she´s doing?" She yelled. Izzie shrugged. She was angry that Meredith didn´t told her but she wouldn´t want her to die or anything like that. "Cristina, I ..." Izzie tried to say. "I was hurt and angry, then I ignored her and started completing charts. Please, I didn´t mean anything like that to happen." Izzie told her. Cristina Yang was furious. She couldn´t handle looking after a patient who is also her friend? How could she be that reckless? How could she?

"How could you?" Cristina paced up and down, looked at her Izzie and shook her head as if she couldn´t believe it.

She looked tense. Nervous. Well, she should be.

Then her pager beeped. She glanced at Izzie, whose pager shrieked at well. "Crap, they are paging us because they have discovered Meredith is gone. They have found out. Damn it." Cristina got out, she was hysteric. Frantic.

_What if they don´t find her in time? _

_What if she dies?_

_So many what ifs._

_And no answers._

"They are paging us." Izzie repeated faintly. God, she is in so much trouble. She did not mean for this to happen. She took a deep breath. For a freak out isn´t the time now. That has to wait for later on, she decided. "Come on." Cristina told her, obviously nervous. Well, she should be. She left Meredith with her, who sneaked away and couldn´t be found by anyone.

They were in so much trouble.

Izzie nodded. Meredith disappeared. Why hadn´t she paid attention to what this girl was doing? She was jeopardizing her own health, how could she be that stupid. Maybe it was partly her fault too. Why did she have yell at her? She could have done so many things differently. Cristina and Izzie hurried through the hallways. Cristina was worried, very worried. She knew from the very beginning that this whole thing was a mistake? Why did she do it then? That was what she did not understand.

Cristina will get into some real trouble for *stealing* Mer from CICU.

* * *

She did it. She sneaked away from the OR Gallery, managed to avoid the nurses and other doctors. She was happy not to be the sick girl anymore, although she still was. But she isn´t lying in a bed in Cardiac Intensive Care Unit. Her heart rate and heart beat weren´t being monitored. She disconnected the leads of it and when it signaled asystole, she shut it down, so that it´s still on but there are no loud noises that could indicate someone is coding even if nobody is. She walked some floors, then to the tunnels where the interns spent a lot of their night shifts.

She enjoyed not being around people who were overly worried about her. But she kind of loved it when Derek is hovering over her, that means he cares ... Meredith smiled. She has Derek and she has Cristina. She doesn´t need more People. Like Izzie said, they were kind of just roommates. Although they weren´t. She'd always considered Alex, George and Izzie as friends to hang out with. But with Cristina? Their relationship was much different in a good way. They understand each other in a way others don´t- Cristina and Meredith have a Special bond. They are each other´s person.

Meredith sat down on one of the beds.

It was a little cold down here. For a second she shuddered. She only wore a thin Hospital gown and it was really freezing down here. Suddenly she felt a little light-headed but thought nothing of it. She ignored the nagging feeling her status worsened in the Moments she spent down here in the tunnels. She took a deep breath and decided she should go back. They will be so worried if she didn´t show up and just disappeared somehow. Meredith was standing in the hallways, next her were patient rooms. Nurses were here, speaking to doctors, doing the stuff nurses do. Nobody noticed her. Then she sneaked into the nearest on-call room. She decided to hide in an on-call room.

She was now feeling incredibly dizzy. "God, not in here." She mumbled to herself.

_Not Again. _

_And yet, nobody was around here ... _

_Crap, this wasn´t really good. _

She tried to breathe equally and regretted her decision to escape from the gallery. Nobody would know where she was and nobody would know where to look for her and Cristina would get into trouble. Damn it. She should have spent more time thinking this through. Then she wouldn´t be in this freaking mess right now.

She worked on controlling her breathing. It worked for a little while, but then it got worse. She really had trouble breathing, also she felt her heartbeat slowing down. Her heartbeat was slowing down noticeable. This wasn´t good. This was like the situation in the Chief´s office. Crap, now she was in real trouble-

She was having arrhythmias again.

She would die in here because she needed to get away. What a stupid idea. Now she might die because of it. She was brainless. Wait, didn´t she call Derek brainless, well now´s she the one who´s not thinking clearly. If she had she wouldn´t be in this mess. She scolded herself for the stupid stupid idea to get away from everybody.

This couldn´t be true.

She closed her eyes. Out of sudden she felt terrible tired. She just wanted to curl up and sleep it off. They whole room was spinning around her. She could barely stop herself from closing her eyes. But who knows if she would wake up then? Nobody can guarantee that she would wake up the next morning especially if she was having bradyarrhythmias right now. She breathed in and out. In and out. Come on, it isn´t that difficult.

Normally.

But nothing about this situation here was normal. She was feeling dizzy as another wave of dizziness hit her and she fell. She almost lost consciousness but fought it off. She isn´t giving up without a fight. If she dies, she won´t go down without a fight.

Her pager. Where was her pager? But she didn´t have it anymore or did she? The dizziness made it so difficult to think clearly. She has to get her damned pager. She wasn´t officially at work. Well, she was but then the unexpected happened to her.

She landed on the cold, hard ground. Her head banged against the wall. Pain shot through her veins and she cried out in agony. She tried to stay conscious after a sharp pain shot through her head. _No. _Her face touched the hard, cold ground ... Meredith breathed in, focused on her breathing and then tried to sit up.

Which was a huge mistake ...

Because of the sudden movement, her world started spinning. She knew was going to pass out soon, but like she did say earlier she won´t give up without a fight. Even though she knew she can´t prevent the inevitable from happening. But even with trying to stay awake, she slowly lost consciousness.

Her heart was now barely beating at all.

* * *

**_A/N: Hey, there. Happy New Year, even though it´s already been four days since new year's eve._**

**_This chapter is a little longer than the chapters before this one. I hope you like it. Thank you for reading my chapter and I really hope you´ll leave a review. Reviews make me really happy ..._**

**_Now we are coming to the medical part of this note. You don´t have to read it. You can also ignore it ... Acyanotic heart defects don´t show signs of cyanosis. The condition of acyanotic heart defect occurs when shunting (flowing) of blood occurs from the left side of the heart to the right side of the heart due to a structural defect (hole) in the interventricular septum. Patients retain normal levels of oxyhemoglobin saturation in systemic circulation. Atrioventricular Septal Defect, Ventricular Septal Defects, Atrial Septal Defects, Patent Ductus arteriosus are acyanotic._**

**_Cyanotic heart defect is a group-type of congenital heart defects (CHDs) that occurs due to deoxygenated blood bypassing the lungs and entering the systemic circulation or a mixture of oxygenated and not oxygenated blood entering the systemic circulation. It is caused by structural defects of the heart (i.e.: right-to-left, bidirectional shunting, malposition of the great arteries), or any condition which increases pulmonary vascular resistance. The result is being the development of collateral circulation._**

**_Tetralogy of Fallot (TOF) is a cardiac anomaly that refers to a combination of four related heart defects that commonly occur together. The four defects are: Ventricular septal defect, Overriding aorta − the aortic valve is enlarged and appears to arise from both the left and right ventricles instead of the left ventricle as in normal hearts Pulmonary stenosis − narrowing of the pulmonary valve and outflow tract or area below the valve that creates an obstruction (blockage) of blood flow from the right ventricle to the pulmonary artery Right ventricular hypertrophy − thickening of the muscular walls of the right ventricle, which occurs because the right ventricle is pumping at high pressure. It is the most common cyanotic heart defect. This "shunting" of oxygen-poor blood from the right ventricle to the body results in a reduction in the arterial oxygen saturation so that babies appear cyanotic. The cyanosis occurs because oxygen-poor blood is darker and has a blue color, so that the lips and skin appear blue. Tetralogy of Fallot is most often diagnosed in the first few weeks of life due to either a loud murmur or cyanosis. Babies with tetralogy of Fallot usually have a patent ductus arteriosus at birth that provides additional blood flow to the lungs, so severe cyanosis is rare early after birth._**

**_Also, I wanted to thank you for reviewing my last few chapters. Keep that up._**


	17. Chapter 17

**Chapter 17**

* * *

**First, do no harm. As doctors, we pledge to live by this oath. But harm happens and then guilt happens. And there is no oath for how to deal with that. Guilt never goes anywhere on its own, it brings its friends - doubt and insecurity. First do no harm, easier said than done. We can take all the oaths in the world, but the fact is, most of us do harm all the time. Sometimes even when we're trying to help, we do more harm than good. And then the guilt rears its ugly head. What you do with that guilt is up to you. We're left with a choice. Either let the guilt throw you back into the behavior that got you into trouble in the first place, or learn from the guilt and do your best to move on.** Meredith Grey; Oh, the Guilt

* * *

When Izzie Stevens and Cristina Yang arrived at Meredith Grey´s room in Cardiac Intensive care Unit, they recognized Dr. Bailey and Dr. Addison Montgomery standing there, looking around the room. They seemed worried and a little clueless. Then Dr. Bailey saw her interns arriving. "There you are." She greeted them with a fake smile. "What is going on?" Within seconds her face expression changed and she stared at them intimidating. Cristina felt Izzie shifting uncomfortably, Cristina herself felt guilty. Extremely guilty. Like she was the one who was responsible for this mess. The only one responsible. And she worried about Meredith and the potentially dangerous situation she was in.

"Where is Meredith Grey? Imagine my ´surprise´ when I came here to check on my patient and ask her a couple of questions and then discover ..." She paused dramatically. " ... she isn´t here. My patient, who should be under constant observation and with people who are ready to defibrillate her if neccessary, is gone missing. How come?" She breathed deep in and exhaled audibly.

"Ahh ... " That is all Izzie could get out.

Bailey shut up her up with a glare and then directed the question to Cristina who looked to the gray ground.

"Can you tell where Meredith Grey is, Cristina Yang? Hopefully you do, because I am not in the mood to waste time on talking." Dr. Miranda Bailey lectured both of her interns, her stupid stupid interns. They are acting like fools sometimes.

Cristina shook her head.

"No, Dr. Bailey Bailey. I am sorry." She answered and looked up. She looked at them aghast and shook her head.

"You´re sorry? Your friend is missing and you are sorry? I really want to kick both of your asses right now-" She stopped abruptly in the middle of her sentence and looked at the two of them with her typical Bailey- look.

Cristina just listened to Bailey. It was the best she could do at this point. She deserved this. All of this, no question. But Dr. Bailey´s ranting couldn´t be compared to the amount of guilt that was stabbing her in the heart at a continous Basis whenever she thought of Meredith and that it was all her fault that this was happening. Why did she have to get coffee? Coffee was the very last thing on her mind right now.

"What did you think you were doing?" Dr. Bailey yelled.

"What the hell were you thinking. Clearly, you were not thinking. Otherwise this wouldn´t have happened." She bellowed. "I made a mistake. I … cannot change it, but I will do everything I can to find her even if I have to search the whole hospital or even Seattle. I don´t care." Cristina sighed. This couldn´t be freaking true. "Then go. We have to find her before anything happens. Guys, this is not some random patient, this is one of us. So, we need to find her now." Cristina said with worry in her voice.

_Her best friend, her person has gone missing and she needs a pacemaker ... _

_If that doesn´t end in a disaster ... _

"We are waiting for Shepherd, he should be here any minute and the other interns. They will help searching for her." Dr. Bailey told them. "So I can be yelled at, right?" Cristina didn´t care if she wasn´t allowed to be in the OR for a month or more. She only wanted Meredith to be here. Safely in her bed in Intensive Care Unit. _S_

_he should have never let this happen. _

_She shoud have never ... should have never ... should have ..._

These words kept ringing in her head. If something happens to Mere, she would never be able to forgive herself.

* * *

"Dr. Shepherd." An OR nurse said, holding his pager in her hands. "Yes, what is going on?" He asked back, he was almost finished with closing when she said: "They are paging you to Cardiac Intensive Care Unit as soon as possible. When Derek got the page, he felt his heart sinking in desperate fear. No, she couldn´t be missing. He almost finished his surgery and when he looked up to the gallery, he saw Yang and Stevens there arguing about something. Then Cristina stopped and looked at her pager and so did Izzie. They got the page too. "Finish up." Derek ordered and left the OR.

_Meredith, why do you keep doing this?_

_She has to be okay, she just has to. _

_There wasn´t another possibility. _

_Except there was another possibility even if he didn´t want it … _

_But why was she yelling at them? _

_Clearly, it had something to do with Meredith. _

_Otherwise I wouldn´t have been paged._

He saw Dr. Miranda Bailey standing there with a worried expression on her face, yelling at two of her interns. She was yelling at Cristina and Izzie. He began running. Maybe it was something serious. He reached them and tried to form words but first he really needed to breathe equally. The others heard him panting and then he started asking questions about what happened.

"What is going on here? Someone needs to tell me what is going on with Meredith." He ordered, his voice shook slightly.

"She is missing." Miranda told him. "She is what?" Derek exclaimed. "How did that happen? How could you let this happen? She has to be monitored 24/7. Weren´t you guys paying attention?" He had trouble forming a clear thought. This couldn´t be happening. Before Bailey even had a chance to answer him, he turned to Cristina.

"It was you, wasn´t it? You did this to her." Derek growled.

"Derek, stop it. Now." Dr. Bailey reacted and stopped the infuriated neurosurgeon before he could do something he would regret. Derek breathed heavily and tried to regain control of his actions.

Cristina looked like a ghost, but still, she tried to explain: "I don´t know what happened. We were in the gallery alone, just her and me. When I left I made sure ... " She suppressed a sob, then continued. "... she wasn´t alone, I left Izzie with her."

"You left her with Stevens?" Derek wanted to know. "She didn´t even know she has something wrong with her heart and you left her with Stevens? That is the definition of irresponsible-" "Shepherd, we already talked about that." Addison tried to stop him. She knew that Derek has sometimes difficulty to control his temper- just like now. "It is the Definition of being unresponsible. Are you out of your mind? How can you do that to a person who is at risk to code? You don´t upset People when they are in that Situation. That´s reckless. Shame on both of you."

"Derek. Derek. Just stop. You gonna make it worse than it already is and blame isn´t gonna find her. And we need to find her, before something goes terrible wrong- so stop, just stop. When we have found her ans she is stable and being monitored in her room in Cardiac Intensive Care Unit then you can yell. Okay. Calm down. Everything´s gonna be okay."

Derek was heavily breathing and tried to get his emotions under control. They were all over the place. "I thought she was safe with you around her. But I was wrong. If she dies, it is your fault. Cristina, that is on you." He hissed. "What is going on here?" A voice interrupted Derek. It was Burke who finally showed up.

"So we better need to find her." Dr. Bailey interrupted, extremely annoyed from Derek who kept blaming Cristina even if she wasn´t the only one who did something wrong. Izzie couldn´t hear it anymore, she doesn´t want to be a coward and let Cristina take all the blame. She was the one who they should blame. She lost Meredith and hurt her, maybe that is what caused her to do that.

"I lost her." Izzie interrupted Derek´s ongoing tirade and caused everyone to look at her.

Even Cristina looked at her.

"What are you saying?" Derek asked, his voice hoarse and filled with worry.

Everyone turned to her, was staring at her. Izzie was standing next to Cristina, wishing she would disappear somehow. But nobody even seemed to notice that she was standing there. Everyone was focused on blaming Cristina for what happened, but nothing of that mattered right now. They needed to find Meredith Grey, before something happens to her.

"Yeah, look at me. I am the one who is at fault here. Not Cristina. She just went to get coffee and then returned. Meredith and I, we fought. I was angry and hurt. Surel, you can think of what we were fighting about right?" Izzie gave a small fake laugh, but immediately went back to normal.

"I ignored her and completed charts, while she sneaked away from the gallery. I never looked up until Cristina got back. She was shocked, when she saw that Meredith wasn´t here anymore. So if you wanna blame someone, blame me. Me. Okay? I hurt her in ways I never should have and I can never take that back or undo the damage I have done. Probably that is the reason for her disapparing. So, now you can yell at me all you want but we really need to find her."

"Stop it. All of you." They could all hear the anger in Burke´s voice as he shut them up.

"We all know by yet that Meredith Grey, one of our own, is missing. I already sent Alex searching all the on-call rooms. If she´s there, he´ll find her and page me. Does anybody know where she might be?"

"The tunnels." Cristina said suddenly. "The what?"

"The tunnels. We interns spent our nights on-call there studying and sleeping on the empty beds in the hallways, so there is a certain possibility that she might be there." Cristina explained quietly, her gaze was directed to the ground as she avoided eye contact with Dr. Burke.

* * *

Dr. Burke scanned his pager, worry could be seen in his eyes. "What is it, Dr. Burke?" Alex asked. He looked impatiently at the older surgeon and waited for his answer. "What is it? Tell me what is going on, maybe I can help." He offered. "Bailey paged us. It is Grey." He finally answered. "_**What? **_It is Meredith? The page is about Meredith is what you´re saying, right?" Alex exclaimed and looked at him. Dr. Burke just nodded. "Yeah, it is about Meredith. She disappeared from her room, her heart monitor and the other devices to monitor her were detached. She is missing."

"What do we do now? She can´t be that far away." Dr. Burke thought for a while, he ignored Alex´s comment and question.

Then he ordered: "I need you to check all the on-call and supply rooms if she´s there. We need to find her before something happens. When you find her, page me right away or let the nurses page me or Dr. Bailey. Check all on-call rooms. We are walking on borrowed time. Her heart could stop beating every second which is why she should be in her room right now." Alex nodded, his facial expression was unreadable. "Yes, Dr. Burke, I am on my way." With that, Alex walked away, then he started running. Dr. Burke watched Alex Karev go, he hurried away.

Alex was searching. Or Burke made him searching all the on-call rooms. He ran along the hallways, he almost ran over a nurse, who carried some medical supplies and was forced to jump aside. All her medical supplies fell to the ground. "Watch it." The nurse called after him. Alex stopped for a second, threw her a quick apology and hurried to the next on-call room he needs to check.

When he opened the door of the first on-call room, he heard terrified screams from two persons, who quickly disappeared under the blankets.

"Get out. Get out. Get out- Room´s occupied." He heard a man grumble indistinctly. "Yeah, yeah, guys, you know the door has a lock, right? Better learn How it works so the next time I don´t walk in on you having sex." Alex scoffed and closed the door. Obviously, Meredith wasn´t in that on-call room, just two people, who decided an orgasm is the best way to relax. Then he saw Sloan writing notes in a patient chart.

"Dr. Sloan." He called out.

"Karev." He said. Alex ran the last few metres to the nurses station.

"Have you ..." He panted. "Have you seen Meredith? Please, tell me you have seen her. It´s important."

"Where should I have seen her? Why are you asking this? Isn´t she lying in Cardiac Intensive Care Unit?" Mark asked back.

"Just answer the question, Sloan." Alex replied. "No, I haven´t seen her. What is going on?" He asked, suddenly confused.

"She disappeared." Alex answered the questions of the plastic surgeon.

"I´ll help you search." Mark said, there was worry in his voice. Derek was finally happy with Meredith, he would be shattered if something happens to her. As his best friend he needed to make sure Meredith was okay, though he hadn´t been exactly the best friend recently. Now he was trying to fix what he had done to Derek- destroying his marriage, even though it was already finished.

"Let´s go." Alex said. "We have friggin' find her before she crashes somewhere alone and we won´t be able to get her in time." "You like her, right?" Mark could not help but ask. "She is like my sister. We aren´t that different, we both haad crappy childhoods and the whole dark and twisty thing. We are like brother and sister, but there is nothing more. I care about her, because she is Family." Alex explained while the men left the nurses Station and hurried away to search all on-call and supply rooms.

* * *

She closed her eyes. Out of sudden she felt terrible tired. She just wanted to curl up and sleep it off. They whole room was spinning around her. She could barely stop herself from closing her eyes. But who knows if she would wake up then? Nobody can guarantee that she would wake up the next morning especially if she was having bradyarrhythmias right now. She breathed in and out. In and out. Come on, it isn´t that difficult. Normally breathing wasn´t that difficult. But nothing about this situation here was normal.

She was feeling dizzy as another wave of dizziness hit her and she almost fell and hit the ground. Before it she ended up in danger she was able to steady herself and get her breathing under control. For a few seconds she closed her eyes. She almost lost consciousness but fought it off. She isn´t giving up without a fight. If she dies, she won´t go down without a fight.

_My pager. _

_Where is my freaking pager? _

_But I don´t have it anymore or do I?_

The dizziness made it so difficult to think clearly. She has to get her damned pager. She wasn´t officially at work.

She leaned against the wall, panting. Struggling to breathe in the amount of oxygen her body needed. She tried to stand up, grabbed the bed for balance while she steadied herself to get out of here before it was too late. She swayed a little and held onto the bed for Support.

When she stood she felt another wave of dizziness hitting her almost instantly.

Her heartbeat slowed down, her breaths were coming quick and irregular. This wasn´t good, she knew it.

The next thing she knew was that she was falling down. She landed on the cold, hard ground. Her head banged against the wall. Pain shot through her veins and she cried out in agony. She tried to stay conscious after a sharp pain shot through her head. _No. _Her face touched the hard, cold ground ...

Meredith breathed in, focused on her breathing and then tried to sit up, which was a huge mistake ...

Because of the sudden movement, her world started spinning. She knew was going to pass out soon. Even though she knew she can´t prevent the inevitable from happening. But even with trying to stay awake, she slowly began to lose consciousness but she fought it off even if it was hard to stay awake.

But she needed to show them she hasn´t given up, though it would be kind of a miracle if she would still be awake then. Suddenly she gasped for air, she couldn´t fill her lungs with oxygen.

_No. I can´t breathe. _

_I need the oxygen, dammit. __Please don´t let me die. _

_I am not finished. I am not finished._

_I can´t leave Derek and Cristina ... I need to breathe ..._

_Why can´t I do that?_

Her lungs felt like they are on ice or like she was drowning. Her head was hurting too. Meredith continued to gasp for air but eventually she succeeded in controlling her breathing, although it was a lot harder. Has breathing ever been that difficult? She couldn´t think straight. She was only half conscious and she tried desperately to keep it that way.

_Time went by._

Meredith got worse over the time. Her heart was now barely beating at all. She is going into extreme bradycardia and her breathing has gotten a lot worse too, her lips were turning blue from the lack of oxygen. Her heart was now barely beating and even breathing was becoming a lot more harder. It was harder than it ever was. It took all of her strength.

She half leaned against the cold hard wall and was half slumped against it. Her eyes were only half open and then her heartbeat was bradying down. She was really bradying down and she couldn´t do anything about it.

_**All she can do is stand by and watch it play out with no guarantees she would still be alive tomorrow.**_

If she was honest, she wasn´t sure if she would ... She hoped, but much time isn´t there. Her breaths came in short gasps and each time it became more difficult. She suffered from Tachydyspnea. She didn´t know if she was suffering from some kind of arrhythmia or if it was a complication caused by the aortic valve stenosis.

Everything around her was spinning. It was a blur. Then the endless fight of getting enough oxygen pumped into her system. She couldn´t fight it off anymore. It was just too much for her. She just blacked out.

Meredith was drifting in and out of consciousness. The room was dark, there were no lights on or anything. The door was closed. Nobody knew she was in here. Nobody was going to save her. She only regained consciousness for a few seconds, but was then pulled back into the dark ...

Her state was declining inexorably.

She doesn´t have much time left until her heart gives up completely ...

_There is only so much her heart can take._

* * *

Mark and Alex already have searched dozens of supply rooms and on-call rooms but they still haven´t found her. But there was one on-call room they haven´t checked. It was the one on the end of the floor. "C'mon, I know where to look." Alex suddenly said. "Where? Say it." Mark turned his attention at the intern who seemed to know where else they could look for Meredith. "We haven´t checked the on-call room on the end of this floor." "Let´s go." Mark said and was already headed to the room.

Alex followed him. When they reached the room, Alex opened the door. It was dark and cold in there.

They couldn´t see anything despite a small shadow near the wall. A shadow that looks like a human.

"Switch the lights on." He told Mark the view directed to shadow near the wall. Without questioning him he did it. The light flickered on and lit up the room. Alex was shocked when the lights revealed a vulnerable figure slumped against the wall.

"It´s Meredith. We need to page Burke. Now." Mark told Alex who couldn´t take his eyes of the unconscious form of Meredith. Without saying anything he ran over to her and the first thing he did was checking her pulse.

Then he shouted: "We need a Monitor and O2 in here now. Meredith, can you hear me?" There was no response. Then he said to Mark: "She is barely breathing and her pulse can hardly be felt, it´s slow and irregular." "Damn it, Grey. Just hold on, I am gonna page Burke 911. They should prepare for the worst." Then a nurse came running bringing them the desperately needed supplies. "Get me an Ambu Bag, I am going to ventilate her manually until they get ready for intubation."

"Here you go, doctor." Meanwhile, Mark reached for the leads and connected them to the electrodes on Meredith' chest. Immediately the monitor made a sound signaling that her heart was barely beating.

"Her heartbeat is slow and irregular. Also, her blood pressure is low. We need Burke and we need to stabilize her so they can do the electrophysiological study." Mark said. He didn´t take his eyes of the heart monitor. After some time, it seemed like an eternity, Burke came running.

"What do we have, get me up on speed on her condition." He ordered. "We just found her in here. She is not responsive and her heart is barely beating at this point. We have already started her on O2. What are we gonna do?" Alex asked worried. He didn´t answer, he just looked at the numbers on the portable cardiac monitor. Suddenly he said: "Heart rate´s 40 and dropping. She is bradycardic due to the AV block. Get me the atropine now. Hurry up."

The monitor showed regularly P waves, but they are not reconciled to the chambers. The atrial and ventricular actions run completely independent of each other.  
Unfortunately, a ventricular escape rhythm wasn´t formed and therefore it was cardiac arrest which means CPR and intravenous medication to stop the arrhythmias. In case it isn´t working there is also the possibility of using transitory pacer Stimulation (transcutaneous, transvenous or transesophageal Stimulation if needed and the drugs aren´t working). It was still some weird kind of bradyarrhythmia. Seemingly, the Second Degree Block progressed to a complete heart block. It can happen in patients with Second-Degree Atrioventricular Block and these patients have a propensity to progress to complete heart block.

"0, 02 mg / kg atropine intravenously. Now. " Dr. Burke commanded and Alex nodded his head, already grabbing a syringe and the atropine.

Mark Sloan began doing cardiopulmonary resuscitation, Dr. Karev injected the medication now and his eyes were stuck on the monitor screen. But there were no changes to the chamber complexes after the first injection. "Damn it, it isn´t working. Unsuccessfully, then load her up 0.01 mg / kg intravenously orciprenaline. Come on, Grey we know you can do this. Come on ..." All three of them, Mark, Alex and Dr. Burke were looking at Meredith` cardiac monitor, hoping there would be any signs of a normal sinus rhythm. Then, suddenly her heart rate went up again. Slowly, but surely it stablized itself. Alex breathed a sign of relief.

Meredith' heart rate has returned to normal.

"Good, she is back. Heart rate is coming back up." Dr. Burke said. Mark just stared at the Monitor, then at Meredith´ face. He just helped saving the life of Derek´s love of the life. He was relieved that she made it. If she had died, Derek would never be the same, so he was grateful that Meredith survived. Not only, because of Derek, also because she was the other member of the _Dirty Mistresses- Club_.

When they got her back, they called for a gurney to get her back to her room, where Dr. Bailey waited for them and prepared everything. There was now a crash cart standing in Meredith´ CICU room in case this repeats itself. Mark said: "Do you need me or can I go update Derek?" "You can go update him, but don´t say anything too specific. I´ll stop by later when I am finished here."

Mark nodded and went to find Derek. He found him pacing up and down the floor. "Derek." He called out. "Mark? Meredith ... She is gone missing." "Not anymore, man. They are working on her as we speak. She is, well, stable. She coded but we got her back after a relative short time." "Meredith isn´t missing? She´s here? Thank God. Wait, is she okay? Is she ..." "Derek, everything is gonna be just fine. Look, we found her in time. She´s alive, but intubated. It´s just a precaution, you know."

"Who is 'we'?" Derek wanted to know. "Karev and I found her in an on-call room. Unconscious, and she was having arrhythmias again." Instead of replying, Derek just hugged Mark. "Woah. What was that?" Mark exclaimed surprised. Derek did not answer. After a few seconds he let go of him and

"But here´s the thing: We have trouble getting her BP up. She is haemodynamically unstable. But, Dr. Bailey got her." Mark tried to explain. He cursed himself for telling him that. So he would be a pain in the ass and that wouldn´t help Meredith. "I want to go see her." Derek suddenly said. "You can´t." Mark replied. "Come here. Sit down." Both men sat down on the floor to wait for news ...

Dr. Burke got a page, while they were desperately trying to stabilize Meredith Grey. Her current state was critical and her sats didn´t look promising. Also, no matter How much they tried what they tried, they weren´t able to get her blood pressure up. It is barely at the point where it could be considered as stable. "Damn it." Preston Burke exclaimed, while screening his pager. "I got a page. It is the ER who is paging me 911. Can you handle it?" Bailey nodded. "We´ll get her stable somehow. Go answer your page." Bailey answered.

"I need an intern. Who is available?" He asked shortly. "Take O´Malley. Stevens and Yang are having a time-out and Karev´s working on Grey´s case. So the only one available is O´Malley." Dr. Bailey told the cardio surgeon and didn´t bother to look around, she had way more important things to do right now." "Then I´ll take O´Malley. Page me when she wakes up or anything else happens."

"Yeah. I´ll have an intern page you." She answered.

* * *

When Dr. Burke reached the Emergency Department, he was called over to a trauma. "What do we have?" He asked outright. Nurse Tyler looked up briefly and said hectically: "Blunt chest trauma in trauma 4." Dr. Burke ordered nodded and reached for his stethoscope and pushed open the door to trauma 4. He listened to the heart and breath sounds from the injured patient. "A couple of broken ribs and besides that, he is tachycardic." "Okay ..." But before Dr. Burke could even finish the sentence, the values showing on the monitor deteriorated rapidly. "A tension pneumothorax." He exclaimed after looking at the monitor screen.

"Okay, we need the portable X-ray machine, stat." Dr. Burke ordered and George O'Malley was brought back to reality. "I need an X-ray of the lungs in two levels. Move. Now. This patient has a suspected aortic rupture." The patient having a really difficult time breathing and color of his skin turned blue Cyanosis. It was difficult for the patient to stay conscious.

"Damn, tracheal shift and unilaterally revoked respiratory sound It's definitely a tension pneumothorax..."

Then he asked for the utensils for an immediate chest tube on the posterior axillary line in the 4th intercostal space. When that did not work, put the drainage immediately medioclavicular the 2nd ICS. When the patient's condition improved markedly, Dr. Burke ordered said with audible relief in his voice: "He is stable now we need to get him to CT. Tell them that we´re coming up." "Yes, doctor." The nurse nodded and grabbed a telephone ...

Dr. Burke and George O'Malley were fighting now to the injured man's life. He had several fractured ribs, and in addition to that an aortic dissection. They opened him up. Dr. Burke let George do the first cut. "Saw." He separated the sternum and then used the retractor. He was bleeding profusely into his chest and both tried their best, but the aortic dissection was severe. There wasn´t very much they could do. "Damn, I can not see anything. More suction." Dr. Burke told him in a sharp voice, his view was on the surgical field. Dr. Burke to the young assistant physician who is desperately trying to make his mentor everything right.

"Yes, I am doing what I can, there is just so much blood." He replied, Burke, however, just ignored him. After a while, he responded: ".?. Then suction faster so that I can see where all this blood´s coming from. But you want to be a freaking surgeon then behave like that," Dr. Burke said shortly, trying to find the source of the bleeding. It was coming from the aorta, yes, but ...

"I can not see anything." Dr. Burke did not want to duel with his junior doctor, he would win anyway - It is as simple as it is: He was the head of Cardiothoracic Surgery. "Okay, this isn´t working. We need get him on Bypass. Maybe that´ll help. What´s his BP? Talk to me." "Seventies and dropping." George answered after a look to the cardiac Monitor.

"But, I ..." George stuttered and faced the heart surgeon looking at what he was doing helplessly. "Be quiet and start suctioning. I need more vision. It is still bleeding to much. I cannot see anything." He clamped off the aorta to get the heavy bleeding under control. But so far, he hadn´t been very successful. But then things got worse, a lot worse. The patient went into functional cardiac arrest ... The patient´s heart was racing, the pulse fell rapidly and everything continued to go downhill ... The monitor signaled a unsteady heart rhythm. Burke exclaimed "V-tach. Damn, damn, damn." But at this point, the patient started bleeding from nose and ears. He was in DIC.

Disseminated intravascular coagulation. "I´ve been loading him up with blood, FFP and Factor VII, but I can´t keep up with the losses." The anasthesiologist interrupted them. Nobody answered him. They were all focused on stopping the arrhythmias the cardiac monitor signaled a shrill tone.

Dr. Preston Burke demanded quickly for the paddles: "I need the internal paddles, fast. Charge to 300. And clear.." George and the others took their hands off the patient and Preston Burke placed the internal paddles on the heart. A power surge went through the man's body. His heart was in ventricular fibrillation. It progessed from ventricular tachycardia to ventricular fibrillation- a potentially deadly arrhythmia if not treated and well, in this case ... He shouted: " I am charging to 400 and clear." Again he put the internal paddles on the heart and then shocked the man on the table, but he showed no reactions ..." Start compressions. Now." He ordered.

"What, me? I ... " "Yes, do it now before it's too late. " Dr. Burke told him. So George began with cardiopulmonary resuscitation and squeezed the heart rhythmically together and stared tensely at the monitor. He hoped the heart would start to beat again. However, it did not look good for the patient ...

Eventually Burke said resignedly. "O'Malley, stop cardiac massage. There is no way he is coming back." But George still hadn´t given up, although the others have. All of the other OR staff stepped away drom the patient. He was too far gone.

"O´Malley, I said stop it, it's over. We cannot do nothing more for him. Call it "But George did not hear him, he fought and continued to do CPR. There was nothing more they could do for him. Eventually, after several minutes Dr. Burke pushed the young surgeon to the side and looked at him prompting.

"Call it."

George O'Malley looked blankly at the clock and said: "Time of death 15:87."

He tore off his surgical mask down angry and left the operating room.

* * *

"Cristina, I need to apologize." Derek came up to Cristina, who leaned against a wall with her eyes closed and tried to regain control over her overwhelming emotions and feelings. And fear. When she heard Derek was talking to her, she looked at him. Silently, Cristina shook her head.

"No, you don´t. I was acting irresponsible and you were right with everything you said."

"No, Cristina. It was wrong to blame you. I was overreacting. I´m sorry." Derek tries to apologize to Meredith´ person.

"It´s okay, Derek. Really, I think I have earned that. It was stupid. I should have never left her alone with Izzie. I knew it wouldn´t work and that it would end in an disaster. I knew and I did it anyway. What the freaking hell is wrong with me." She asked, she was almost crying.

"She just wanted to see your surgery. I didn´t kn ..." She broke down in tears. Derek didn´t know what to do. Cristina Yang never cries. "Shhh, it´s okay. It´s okay now. She´s stable and under constant Observation. Meredith is stable right now and I spoke to Burke. He said you´ll still do the EPS tomorrow."

"Don´t try that McDreamy-Face with me. It doesn´t work for me. But you said he gave the go ahead? What about her head CT. Do you have the results? Is she okay? God, How could I have let this happen?" She repeated. She suppressed a sob, Derek didn´t really know what to do. Cristina cared about Meredith, if she didn´t she wouldn´t be standing here and blame herself for what happened.

"It´s okay." Derek tried to comfort her. "You would never hurt her intentionally. We all make mistakes. You need to stop blaming yourself and try and forgive yourself." "But how? She almost died because I left her alone? How am I supposed to move on and forgive myself for a mistake that easily could have killed her?"

"There is no ´what if´. She is alive, Cristina and that´s all what matters right now." Derek tried stop Cristina from blaming herself. Then he saw Burke coming towards them. Cristina wasn´t sure what do to. She screwed up. Really screwed up. What the hell did she think when she was leaving Meredith alone with Izzie. Why did she even sneak her out of the Cardiac Intensive Care Unit? What the freakin' hell was wrong with her?

* * *

**_AN: Hope you liked this chapter. I´ll try to post the next chapter as soon as possible ..._**

**_Disseminated intravascular coagulation (DIC), also known as disseminated intravascular coagulopathy or less commonly as consumptive coagulopathy, is a pathological process characterized by the widespread activation of the clotting cascade that results in the formation of blood clots in the small blood vessels throughout the body. This leads to compromise of tissue blood flow and can ultimately lead to multiple organ damage. In addition, as the coagulation process consumes clotting factors and platelets, normal clotting is disrupted and severe bleeding can occur from various sites. DIC does not occur by itself but only as a complicating factor from another underlying condition, usually in those with a critical illness._**

**_Acute DIC develops when sudden exposure of blood to procoagulants (eg, tissue factor [TF], or tissue thromboplastin) generates intravascular coagulation. Compensatory hemostatic mechanisms are quickly overwhelmed, and, as a consequence, a severe consumptive coagulopathy leading to hemorrhage develops. Abnormalities of blood coagulation parameters are readily identified, and organ failure frequently results. _**

**_Traumatic Aortic Rupture, also called traumatic aortic disruption or transection, is a condition in which the _****_aorta_****_, the largest _****_artery_****_ in the body, is torn or ruptured. The condition is frequently fatal due to the profuse _****_bleeding_****_ that results from the rupture. Since the aorta branches directly from the _****_heart_****_ to supply _****_blood_****_ to the rest of the body, the pressure within it is very great, and blood may be pumped out of a tear in the blood vessel very rapidly. This can quickly result in _****_shock_****_ and death. Thus traumatic aortic rupture is a common killer of victims of _****_automotive accidents_****_ and other traumas. The condition is difficult to detect and may go unnoticed, because many patients have no specific symptoms. _**


	18. Chapter 18

**Chapter 18**

* * *

**There's this thing that happens when people find out you're a doctor. They stop seeing you as a person and begin to see you something bigger than you are. They have to see us that way, as gods, otherwise we're just like everyone else, unsure, flawed, normal. So we act strong, we remain stoic. We hide the fact that we're all too human. Patients see us as gods or they see us as monsters. But the fact is, we're just people. We screw up, we lose our way. Even the best of us, have our off days. Still we move forward. We don't rest our laurels or celebrate the lives we've saved in the past. Because there's always some other patient that needs our help. So we force ourselves to keep trying, to keep learning. In the hope that, maybe, someday we'll come just a little bit closer to the gods our patients need us to be. **An Honest Mistake; Meredith Grey

* * *

"It's okay." Derek tried to comfort her. Cristina didn't look like she believed him. She felt like she failed her best friend of all people. The person whom she needed the most, who always has been there for her – she had hurt Meredith by leaving her alone. For a cup of coffee. She couldn't believe that this was her. That she was the kind of girl who leaves her sick friend to get a cup of coffee. Derek sighed. He knew it wouldn't be easy for her to forgive herself. Cristina only saw the damage that has been done and not the rest. "You would never hurt her intentionally. We all make mistakes. You need to stop blaming yourself and try and forgive yourself." Derek advised her, he wasn't angry with Yang. Sure, maybe if she stayed this wouldn't have happened but placing blame is not going to help Meredith. Cristina looked at the neurosurgeon, feeling an uneasy feeling invading every cell in her body. She looked at him helplessly. She studied the neurosurgeon's face, he was eerily calm and composed but she knew that this was just the outside, not the inside. "But how? She almost died because I left her alone? How am I supposed to move on and forgive myself for a mistake that easily could have killed her?" "There is no what if. You can't keep playing the 'what if' game. She is alive, Cristina and that´s all what matters right now." Derek tried to stop Cristina from blaming herself which was particularly difficult. Then he saw Burke coming towards them. He couldn't help but feel thankful. Then Burke could deal with an emotionally destroyed Cristina. Cristina wasn´t sure what she should do. She screwed up, really screwed up. What the hell did she think when she was leaving Meredith alone with Izzie? Why did she even sneak her out of the Cardiac Intensive Care Unit? What the freakin' hell was wrong with her? She couldn't help but keep thinking this.

Cristina had no idea what she was thinking. And now Meredith was hanging on by thread. It was her fault, she should have known that this could happen. Dr. Preston Burke suddenly stood next to them. Cristina held her head down, not able to look her boyfriend in the eyes. Burke sensed this. "Cristina." He said her name.

Derek looked and him and asked, not really caring about the patient, all he cared was Meredith and she was not conscious at this point: "Well, how´s your patient?" He did not really care about that patient but he asked anyway. "He died due to Aortic dissection which is almost impossible to catch in time. I have to inform the family. The nurses contacted his wife and she is sitting in the waiting room waiting for News." Burke told him the short version. Derek didn't reply. Cristina avoided, clearly avoided his gaze, she probably feared she'd get lectured. Burke considered this but then he thought of the guilt she must be experiencing and that that was a lesson enough. There was no need in telling her what she'd done wrong, 'cause she knew exactly what she'd done wrong. "Then I am taking Cristina home. It's been a long day for us all." He added. "That might be for the best." Derek agreed with the cardiothoracic surgeon.

"Meredith? Did you check on her?" Cristina asked quietly. Burke shot her a look and then shook his head.

"After I tell the family ... Then I am going to check on Meredith, then I´ll take Cristina home." Dr. Burke told Derek. Cristina did not protest, which was unlike her. "Will you watch her ..." Derek just nodded, he know what he meant. Burke nodded an almost imperceptible nod. Since only Derek paid attention, Cristina didn't see it. Burke tried to lock eyes with Cristina but didn't succeed. So he just said, softly: "I'll be right back." With that he left, leaving Derek and Cristina standing there, in the hallway not sure what to say to each other. Cristina was Meredith's family and family is there for each other. That's what family's for, Derek thought. So yeah, he would wait here and make sure Cristina's okay until Burke's back. Then he will go sit by Meredith's bedside. Cristina didn't say anything. But that was okay with him. There was no need to talk. It was Burke´s part to do since Cristina is his girlfriend.

"I just can't stop." Cristina suddenly said and shook her head slowly.

"I can't stop blaming myself. What if it never ends?" Cristina questioned herself, feeling the crushing feeling lingering on her.

Derek never answered her. That she had failed Meredith when she needed her. She couldn't get over that easily. That was absolutely not possible. All her thoughts were driving her crazy and she just couldn't do anything to stop thinking about Meredith and the possible consequences.

Silence between them two. "I can't stop, dammit." She repeated, a lone tear escaping her eye. Derek had never seen Cristina Yang so emotional over something. She really did care about Meredith. That was now clearly visible and Derek was glad that she had a friend like this. She would need a good friend like this after the surgery, a friend who was with her and supporting her the whole way through. "I just … I keep having this image in my head, of her lying there and not moving." Cristina rambled. "It's okay, she's okay now and you will be, too." Derek said as he awkwardly patted her back. Talk about awkward. Because this, this was definitely something awkward for the both of them.

For a moment Derek just listened to what Cristina told him.

Then there was there a long pause. Nobody said or even breathed a single word. Then Derek interrupted the silence between the two doctors: "It'll pass, somehow. Just keep the faith. You can do this, Cristina." She sniffed quietly and lowered her gaze to ground, to same spot she had been staring for the past half hour. "You made a mistake. But it doesn´t make you less of a doctor, it makes you human. Mistakes are human. You are human."

"I know but ..."

"There is no 'but', Cristina." Derek told her in a strong and determined voice to let Cristina know that he was right, that there was no 'but'. Cristina glanced up, then she muttered a silent 'thank you' to Derek. "It's what family's here for. Even though we're not close, you and Meredith are. She's lucky to have friend like you. Don't let this get in the way your friendship. She needs you, Cristina." Derek dug out some advice. Cristina slowly nodded. She liked Derek more and more. Fortunately, Dr. Burke was coming back in this moment to take Cristina home. "Thank you." He said to Derek whereupon he replied: "No problem. Just take her home. I am just going to see Meredith. I am staying overnight." Cristina said nothing all the ride back to their apartment.

Her head was leaned against the cold, hard headrest and she just watched the streets go by. Everything else, she tuned it out. She knew Burke was trying to get her to talk but she simply shut him out and there was nothing else he could do about that so he just has to go with it. After a while, Preston Burke let it go and concentrated on the traffic. Dr. Burke was driving the car. He did not say anything, he just looked at her a few times before his focus went back to the traffic. "Cristina." He suddenly said, trying to get her to talk but nothing, Cristina just blocked it out. Ten seconds later, he asked again, "Cristina, are you even listening?" But there was no reply or comment or reaction in any way coming from her. She's got to take this thing with Meredith very hard. This was very Cristina-unlike behavior, Burke thought without saying anything.

"We're home. If I were you, I'd grab my things and walk inside." Burke said as he turned onto the parking lot and the car came to a hold. When they arrived at home, she just took her bag out of the car without any words and followed her boyfriend into their Apartment and disappeared into the bathroom as soon as Dr. Burke unlocked the door of the apartment. Then she locked the door behind her. Dr. Burke was unsure if he should talk to her but in the end he decided against it. It was perfectly clear that she just needed some time to herself after all what happened today.

So now she finally cracked under the pressure.

Cristina hid in the bathroom. Not hiding, really. But she locked the door. Preston went to the kitchen and started making coffee. "Should I order takeout food or should I cook for us?" He asked a closed door. He heard Cristina mumbling something, but never heard anything that makes sense to him. He decided he would cook 'cause he wasn't a real fan of takeout food.

Cristina didn't listen to Burke. He said something about food, which wasn't the very important thing on her mind. She leaned against the wall, trying desperately to think about something else.

She has to move on, Derek was right on this one.

Otherwise she'll define herself about what happened and will never be able to move on.

It'll keep her from becoming the brilliant, world-class and badass surgeon she always wanted to become. So she needed to freaking let go- but it was easier said than done. Dr. Burke seemed surprised when he saw Cristina unlocking the bathroom door and walks, without noticing him, into the kitchen and rummaged in the cabinets.

Dr. Burke leaned against the countertop and watched her.

On his face a small hint of a smile could be seen and he watched Cristina was obviously looking for something. "What are looking for? Maybe I can help you out." She didn´t answer and he did not expect her to answer.

"I need a drink. Damn it, why ..." She started, paused and then continued: "Where is the freaking tequila? Why haven´t you got tequila in your home?" She asked him. "I don't have Tequila in my house. I don't drink Tequila, you and Meredith are the only ones doing it. I don't even have beer or something so there is nothing alcoholic that you could drink. But what about a glass water and maybe taking a shower, you could do that right? Cleansing and so on, maybe it would do something for you." Burke offered. Cristina merely scrunched her face in disapproval.

"Meredith always has stuff like that in her house." She grumbled to herself and left the room. Burke was standing there and saw Cristina walking away, she'd experienced a no good, very bad day. "How is that even possible?" She called out somewhere away, Preston had no idea what to do. He knew she was still talking about him not having any tequila in the apartment. Finally, coffee was ready. He poured himself a cup, then called Cristina´s name and if she wanted some too. "You want some coffee as well?" He asked loudly but never received an answer.

He never got an answer. Then he searched the Apartment for his girlfriend, looked through every room and finally he found her. "Cristina …" He said her name, she was not responding. From his point of view, she was nearly catatonic. This was not good. He knew what sent her into that state. He found Cristina sitting on their bed, staring into nowhere. He sat down next to her and touched her lightly on the shoulder. She then flinched.

"Hey, it's just me, Preston." He said.

Cristina looked up, Burke noted the slight movement of Cristina. "Nobody calls you Preston." Cristina replied stubbornly, she always refers to him as Burke. He chuckled. "My Mama does." He couldn't help but say that to her. Cristina wrinkled her nose and replied: "Mama?"

"Forget it!" Preston immediately recognized his mistake.

Cristina was *allergic* against anything that has to do with the word family and parents. "Thank God." Then she leaned back into the pillows and stared at the ceiling. Burke joined her and both of them laid next to each other on the bed, cuddling.

"Do you think she'll survive?" Cristina asked.

"I mean this won't be easy for her." She stated the facts. Burke wasn't sure what to answer. "There's a risk to every surgery, Cristina." He began, vague. Cristina snorted. "Don't give me that crap. I know the odds. I've done the research. I know what the chances are. But I need to hear it from you, what you think about it." Cristina sounded desperate. "You're scared. I can see that." Burke replied. "Of course I am scared. Meredith is the best friend I have ever had and she's like my sister. So yeah, worried." She kinda snapped. Burke wasn't hurt by that. He felt she was scared out of her mind and what happened today wasn't really helping matters.

"It's okay to be scared. It means you've got something to lose." Burke added.

"I can't tell you that the surgery will be without any complications. I can't do that. There is always a chance something unexpected happens and then there you go … I can't tell you everything will be alright because I don't know." He confessed. "I can't say anything besides that this wasn't very helpful." He referred to today's situation.

"I can't stop thinking about this." Cristina suddenly confessed. "Do you want to be distracted?" Burke asked, having a certain thing on his mind. "No, I don't. I can't, I am sorry." "But why not? Meredith us being monitored constantly, they have great nursing staff and great doctors and I am sure Derek won't leave her side for a second. So name me one reason why we can't do it?" "I can't … I can't have sex with you when my best friend is fighting for her life." Cristina told him, serious about it. For a moment, no one said anything.

A loud beeping noise startled them out of their daze. Burke knew he had placed his pager on his nightstand. "It's bad isn't it?" Cristina asked startled, as she was already fearing the worst and imagining horror scenarios of what could be since chances are that this page is about Meredith. "Oh my god, she is coding isn't she?" She screeched panicky. Burke searched for his pager. "Where is my pager? Have you seen it?" Burke asked a frozen Cristina.

"Ah, there it is." He threw a short glance on it and told Cristina to get up. "No she is not coding." Burke finally answered. Cristina released a sigh of relief. They need to go to the hospital. "Why?" She asked terrified, something could have happened to her person.

* * *

Derek was sitting on a visitors' chair next to Meredith's bed and stared at the heart monitor. It showed a normal sinus rhythm. He watched every beat of her heart. Then he looked at the vent that was connected to the endotracheal tube. Why did she do this to herself? He couldn´t help but think that. Why would she do that to herself? Maybe she was hurt and just wanted to leave ... But that almost killed her if they hadn´t found her in time. Wait, Mark. He should talk to him and he really should thank Alex for finding her so quickly. He sighed. Why can´t be life easy on them just for a little while? Maybe they will be able to life their lives after everything was back to normal, after the surgery ... Maybe then ... they could live a normal life, at least for a little while. He didn´t remember falling asleep with his head lying on Meredith's chest so he could hear a heartbeat. He was just so tired and suddenly falling asleep.

It had been a really long day on all of them ... So he just let go and soon was asleep.

When he heard Miranda Bailey´s voice in his ears, he slowly woke up. Slightly confused he looked around with half opened eyes and eventually he recognized Dr. Bailey standing next to him, seemingly checking Meredith's vitals and the monitors. Instantaneous, after hearing her say, asking him: "What are you doing?" He heard himself being asked a question. But he never responded at least not coherently. Derek lifted up his head and looked at her. His blue eyes focused on Dr. Bailey. Then he looked back at the motionless figure lying in this bed and it just kept tearing his heart seeing her like this. She had not woken up since they've found her. But at least they got her blood pressure up and that only after Bailey told them to hang on some infusions and letting them run wide open. She was stable. And that was something.

He looked up, checking her monitor for any disturbances. She was still on high flow O2 to make sure that there is enough oxygenation. She was on PEEP. Positive End Expiratory Pressure to protect the lung tissue. Also, she was getting tons of heart medication to make sure her heart functions as 'normally' as possible. She was getting diuretics and medication to reduce afterload intravenously. Plus, she was on beta-blockers. Bailey went over to Meredith's head and was checking the inserted central line. But for now, everything seemed to be working. Meredith was receiving her medication to treat acute heart failure due to decompensated aortic stenosis until they could do the procedure.

Derek sighed. He knew this would happen eventually. Her needing a new heart valve but he had totally forgotten Bailey was still in the room.

"What are you doing?" Dr. Bailey repeated and gazed at the neurosurgeon that apparently fell asleep on his girlfriend´s chest in the CICU. "I was ... sleeping." Derek answered, yawning. "I see, but why in here?" She wanted to know and glanced at the monitors surrounding Meredith. The numbers seem to please her and she scribbled something down in the patient chart. Derek watched her attentively. I hope you save me 'cause I am already falling. The world is coming down. He was her knight in shining whatever.

"What are you writing?" Derek asked anxiously, his heart was pounding heavily against his ribcage. "Just that she´s stable and her vitals are in place." Miranda immediately calmed the neurosurgeon down, knowing he'd freak out completely otherwise. Derek nodded relieved. But Miranda wasn´t finished. "You didn´t answer my question." She insisted, she was not going to back down. "Am I obligated to answer your questions? I am your boss and not the other way around." Derek answered wearily. "Well, in here you aren´t my boss, you are a family member of a patient." Dr. Bailey glared at him, before she continued: "What about my question."

"God, you are so damn stubborn." Derek groaned in exasperation.

Dr. Miranda Bailey smiled mildly which caused Derek to sigh loudly and then he explained: "I couldn´t leave her." _Cute._

"You know there are on-call rooms on this floor, for doctors if they stay overnight. Working ... They have beds, decent beds where you can lay down without having a sore back when you wake up. I'm just saying. I can have a nurse page you if her condition changes." Bailey suggested. She only wanted to help and Derek knew that. "I won´t leave her. I have left her a lot of times, but I´m here now and nothing´s going to change that." Derek gave back, unable to look away from Meredith's face. "I can't do that do her, not again. This is when she needs me and my support. I'm not leaving her." He said sounding sure about it.

"Okay." Bailey replied and turned around. "Good. But remember, she's a patient right now, not an intern. I am just saying take care of her." She added. Derek scrunched his brows. Somehow, this did not add up but he didn't care much. "Speaking of which, I am supposed to do a blood gas analysis on her to find out whether there is sufficient oxygenation and ventilation, and it's a good way of detecting any kind of base excess. " Bailey said causing Derek to look up. "Why would she need such a procedure?" Derek asked, right now he wasn't a doctor, he was family. "I need to get the needed equipment so we can do this bedside." Bailey said. "I'll be right back with the supplies." Derek frowned. He knew that patients in ICUs were supposed to get those blood gas analysis's every 3-6 h but Meredith – that seemed to be so far away. But apparently, it wasn't. He hoped the values would be good. It was important for them to be good. Then Bailey entered the room, she was bringing a modern so-called POCT machine with her so that she was able to do Point-of-Care Testing, so she would be able to get the parameters she wanted bedside.

"I mean it, I won't leave her this time. Even if it means sitting here the whole night and waiting for her to wake up. I will not leave her. She is probably scared out of her mind, even though she isn´t conscious. So, no, I am not leaving." Derek stayed calm when said this, his hand was gripping tightly onto Meredith's small, delicate hand. He felt that her hands were cold. They always have been, he told himself. That was nothing big. "Okay." Much more she didn´t say. Then she left the room, leaving him alone with Meredith. Derek looked at Meredith's face. He hoped she'd regain consciousness soon so that they could remove the tube. He cupped her cheek with his hand and whispered: "C'mon, Mer. I am waiting for you to open these gorgeous blue eyes of yours." He said, realizing that nobody had tried this before.

* * *

"What did you do, Izzie?" George exclaimed when he waited for the blonde doctor at the entrance. Izzie finally came. She had her head down and was trying not to look at him. It was as if she was hiding something. Izzie Stevens just couldn't keep a secret to save her life so George knew it would be easy to find out what happened today. "What are you talking about?" She tried to sound innocent and like she did not know what he was talking about. But she knew what he was talking about ... The incident with Meredith that almost cost her life if Alex and Sloan hadn´t found her in time to prevent the inevitable. "I ... I ..." She did not know what to answer. George watched her attentively.

This wasn´t exactly like the Izzie he knew. Izzie could talk, I mean, like really talk. "Oh, come on, Izzie. Say something." George wanted her to explain it to him. He wanted to know if the rumors were true and apparently, the way she acted they were. "What am I supposed to say? What do you want to want to hear from me?" She was determined to not tell him everything. "Deal with it, George. I am not telling you anything." That was her last word but George was sure she'd eventually cave.

"You are acting weird." George noted suspiciously.

Izzie just shrugged and searched for the car keys. "Damn it, I cannot find them." She said annoyed when she discovered that she couldn´t find her damned keys. "What? Are talking about your keys? Have you lost them?" George asked, he tried to be helpful even if Izzie wouldn´t tell him what happened. "I don´t know. I don´t know anything right now. My head is empty." Izzie whined to him while searching her handbag over and over Again. But she couldn't find it. This day's really fucked up. She hated this day.

"Let me help you, Iz." George said. "No." Izzie told him rigorously. "I don´t need help. I am fine with things the way they are." "But I am not. I want to go home, now. I need to be ... You know? Fine. We take my keys ..." He didn't finish the sentence because suddenly he saw something on the ground. It looked like car keys. "I think I have just found 'em, Iz."

"Found what?" Izzie asked, still searching in her bag.

"The keys for the car." George rolled his eyes. Without saying anything she grabbed the keys out of his hand and stormed to their car, or more like Meredith's car. George followed her. "Let me drive, Izzie. You're in no condition to drive a car. I don't know what happened but it's perfectly clear that you can't drive a car in your current state." "Bite me." Izzie gave back, still not handing out the car keys. "Give. Me. The. Keys. Izzie, I am not going to argue with you on this one. You're clearly worked up and I won't let you drive when you are like this." George tried to persuade her. "Fine." Izzie gave in as she gives him the keys back. George tried to talk to talk to her when he was driving the car. When they arrived at home, Izzie immediately went to the kitchen and started pulling out all sorts of things you need to bake something. Baking is Izzie´s way of coping with something.

"It is 9 PM in the evening. Why the heck are you starting to bake yet?" George asked.

"Go away, George." Izzie grabbed a pack of flour and started baking chocolate muffins. George shook his head and was about to leave the room when he heard Izzie saying: "George, can you drive to store? We don´t have sugar anymore and I need it for the muffins. Please, George." She tried to convince him and offered him her nicest smile. "Are you serious? It´s 9 o´clock in the freaking evening and you want me to go to the store to get you sugar for your cake? Are you serious?" He asked incredulous.

"Seriously?" He added.

Izzie didn't seem to think any of it. "Yes, I am. Would you please be so nice and do it." She just said. George just gaped at her with an opened mouth. "For your friend, your best friend." Izzie answered, while rummaging in the cabinets.

"Only if you tell me what happened." George blackmailed her.

"Just go get the damn sugar." Izzie exclaimed.

"No." George simply replied.

"I am not doing this anymore. You know you think that I am just Georgie. But that stops now. I am sick of just being sweet, nice Georgie. I am George, surgical intern just like you, Meredith and Cristina. Start with respecting me, then I will buy your damn sugar as long it´s not 9 o´clock in the evening." George let it out. Izzie stared at him. These things have to be said, otherwise nothing will ever change.

"I´m sorry for the way I behaved, George. I really am." Izzie finally answered.

She caved. "It´s okay." George said. "It´s not." Izzie answered and sighed. "I was angry and I didn´t mean for all this to happen. You have to keep that in mind." George slowly nodded. He didn´t know what he should do. "When I heard about Mer´s ... you know, birth defect and I was ..." "... shocked." George offered. "... shocked and hurt. When Cristina paged me to monitor her for a few minutes so that she can get herself coffee, I confronted her ..."

"... which turned out to be a huge mistake, am I right?"

Izzie nodded. "You are."

"I should have never done it. I said some things I regret and I cannot take them back. Now she is lying in CICU with a ventilator that is breathing for her." George looked at the blonde woman who leans on the countertop. "She´s what?" George forgot for a moment how to breathe. He had loved her when they started their internship together but he had to accept that he never will be her boyfriend.

"A ventilator is breathing for her. It's my fault." Izzie told him, slammed the pack of flour unheedingly back on the countertop. "It's my fault." She repeated.

Her words were repeated over and over in his head.

"Nobody says it but they all think it. The universe is punishing me for doing something like that to my friend." Izzie confessed. "It is my fault. I should have never hurt her like that. I knew she was ..." She stopped, suppressing a strangled cry. George never said anything, just went up to her and embraced her. It was the only thing he could do to make her feel better.

"She´ll be okay." George murmured in her hair. "She will be. Mer´s tough, you know. When somebody can survive something like that it's her. She´s been through more than any of us and still, she got through it. She´ll get through this. I am sure she will."

"Thanks, George, for being my friend."

* * *

A loud beeping noise startled them out of their daze. Burke knew he had placed his pager on his nightstand. "It's bad isn't it?" Cristina asked startled, as she was already fearing the worst and imagining horror scenarios of what could be since chances are that this page is about Meredith. "Oh my god, she is coding isn't she?" She screeched panicky. Burke searched for his pager. "Where is my pager? Have you seen it?" Burke asked a frozen Cristina.

"Ah, there it is." He threw a short glance on it and told Cristina to get up. "No she is not coding." Burke finally answered, he seemed totally relaxed. He was the total opposite of Cristina. Cristina released a sigh of relief. They need to go to the hospital. "Why?" She asked terrified, something could have happened to her person.

"Derek just paged me. It says here that she's awake."

"She's awake? Meredith is awake?" Cristina asked, her eyes lit up instantaneously. Burke nodded. "Let's go." He said, holding out his hand and to his surprise, Cristina took it. It was raining outside but for once they didn't care at all. All that mattered was that Meredith was awake.

* * *

Weird sounds were greeting her when she opened her eyes just a little bit. The light was very bright when it hit her eyes. Immediately she squeezed her eyes shut to protect them from the light. Meredith tried to recognize where she was. When she tried to breathe, she felt something blocking her trachea. A tube was down her throat, probably to help her breathe but right now she felt like she was choking. Panic shot through her veins and she tried to make someone help her. Help, she needed someone to remove it. Someone should remove the damned thing. It was keeping her from breathing from her own. When she turned her head to the left, she saw the heart monitor that was monitoring heart rate, blood pressure, central venous pressure, pulse oximetry, kapnometry and kapnography, Meredith turned her head to the other side but there was no one in the room that could notice that the patient was lying there, awake and aware of everything that happened.

She felt something heavy lying on her chest and caught a glimpse of Derek´s black hair. He was there, he was there. It's what she held onto. Everything would be okay when he wakes up. She tried to calm down and shifted slightly. C'mon, wake up, Derek. This movement caused Derek to wake up and noticed his girlfriend has regained consciousness and she was breathing over the vent. They can extubate her. "Meredith." He said, grinning happily, obviously elated.

He was happy that she was awake, she guessed. But she wanted that damned tube removed.

It keeps her from breathing on her own.

"I will get Burke. Stay calm, Mer. He will be here soon." Derek grabbed his pager and paged Burke and Dr. Bailey. They immediately came running. Dr. Bailey entered the CICU room at first. "What's going on? Why was I paged?" Bailey asked as she stomped into the room. But before Derek could say something, her gaze wandered to the heart monitor and checked her rhythm. It was normal, just as her blood pressure thanks to some infusions to stabilize it. When Burke entered the room, followed by Cristina, he checked vitals and breath sounds and then the cardiothoracic surgeon said: "She is ready to be taken off of the ventilator. Prep for extubation. When I remove the tube I want you to breathe out when I start removing it. On my count ..." Meredith blinked to show him that she understood what he wanted from her.

"One ... two ... three, and tube's out." He counted and slowly and carefully removed the tube.

But still, it was uncomfortable either way for Meredith but she got through it. Derek was with her the whole way through and he was doing the best he could to comfort her-

After giving her some time, Burke cleared his throat. "Do you remember what happened to you, Meredith?" Dr. Burke asked after he removed the tube that helped her breathe. Meredith didn´t answer right away. Her throat was still sore from the intubation.

"Meredith?" Derek asked. "You remember what happened or why you are here?" Meredith looked between Derek and the other doctors in the room. Why were they staring at her? Then it came back. The memories came flooding back into her brain. "Yeah, I ... re ... remember." She croaked. Her voice was scratchy. Derek smiled happily. His Meredith was awake and responsive and she remembered what happened. Relief flooded through his veins and he let out a breath he didn´t knew he was holding.

"I love you ..." She mouthed towards Derek, who replied with a kiss on her cheek. Derek just smiled and then he sat down on the edge of her bed in ICU. Meredith was watching him with big eyes, she had no idea what he had in mind. "Derek." Meredith said. "What are you doing?" She asked, showing interest. "I am going to lay next to you and hold you and stroke your hair 'cause that's what I want to be done if I'm sick." Derek smiled at her. Meredith had a smile on her lips as well.

These few moments with Derek were worth it, they were worth everything.

The small things are what matters, she suddenly knows it.

Meredith made place for Derek what was a bit difficult but eventually they got it right. Derek was now embracing Meredith and for now, they enjoyed a little bit of peace and quiet.

The next day, Dr. Preston Burke, head of cardiothoracic surgery, knocked on the door. "Yes." Cristina said questioningly after the cardiothoracic surgeon entered Meredith's CICU room. Derek was there too. Where else should he be? Meredith was laughing about a joke and Derek looked like he didn't enjoy the Meredith and Cristina freak out time at all. But he stayed 'cause he loves Meredith and wants to spend every moment with her until … "Can I take Dr. Grey to cath lab now? Would that be possible?" He asked. "Sure you can, Dr. Burke. Meredith is ready for cardiac catheterization study." Cristina said. She was ready for it, they did run preparatory blood tests and they also did a repeated electrocardiogram. She also signed the needed consent forms.

"But can you ..." He nodded.

Dr. Burke watched the twisted sisters talking. He concluded that they needed a moment before heading to cath lab. Suddenly Dr. Bailey was standing next to him. She was watching the scene. Meredith Grey getting prepped for a diagnostic cardiac procedure and Cristina and she were talking as if was nothing wrong. Bailey shook her head. She should have foreseen this. She confronted Meredith about the cyanosis. Why didn't she drag her to Burke? "Can you believe it?" She quietly asked. "I mean, she´s one of the most promising interns I've ever seen and now we're about to take to cath lab. One my interns needless to say, obviously they don´t know how to stay out of trouble ... But in her case it is not really her fault and even less her own choice." She added coz it was the simple truth.

"Yeah, how come I didn't notice the signs? I mean this worsened over months." Burke just stated the obvious.

Bailey breathed in sharply as suddenly she knew how they were able to hide this for so long. "Shepherd and Yang covered for Meredith. When she wasn't feeling well enough to do something and it was intern work then Yang would take over." Bailey remembered that Cristina often switched with Meredith when there was something going on with her. "Additionally, Meredith was often on Derek's service and I am pretty sure he knew her limits. He was watching over her like a hawk that she didn't do anything too strenuous that might interfere with her heart and cause problems." She explained.

"That might be true." Burke nodded in affirmation.

"I am still wondering why we did not notice it the whole time. How could we not notice that something was seriously wrong with her? We are doctors." Bailey silently told him, making hand gestures to underline what she says. She was angry that she did not notice the signs.

Burke looked at her surprised that Miranda was confiding in him.

"There were signs, yes. But you didn't let it go, Miranda. You talked to the Chief about it and when you questioned Meredith, she collapsed. I know it sounds to you like it's somehow your fault for not noticing but Yang and Shepherd covered for her for months. I should have known something was going on. Cristina started acting differently, she started researching about pediatric heart conditions and treatment options … I should have known. "It's been months and they almost finished the internship. They soon will start residency and have their own babies." She added.

"I know. It's unimaginable that this concerns one of our own?" Burke asked as he watched Grey and Cristina interact.

Bailey nodded, seemingly caught up in thoughts. "It is. I don't know why she never said a thing. Why did she let this get this bad? I don't understand that. She's a doctor. She knows she has got to get her heart checked regularly." "Sometimes people do stupid things."

"Okay, I'll stop by after the examination and I will be there when they do it to make sure you don't, well ..." Cristina did not end the sentence. "I hope so. I will not be anesthetized, I am just numbed with a sedative and therefore I am gonna be awake during the whole procedure, Cristina." Meredith said merely with a wry grin to Cristina. The intern laughed in reply.

"Right, just don't pull anything funny on me you, understand? Gotta go, see you in there." She said before she left. "I'll try, but I can´t promise anything." Meredith answered simply. A spark was evident in her eyes. "I don´t want to lose you and I think McDreamy thinks the same." Cristina countered. "I know. It´s not that it was my choice to be born with a complex CHD. Nobody chooses that voluntarily."

"You're right. I see you in cath lab." Cristina said before leaving the room.

When Cristina was leaving, Meredith noticed Bailey standing next to Burke. "Dr. Bailey. What are you doing here?" She asked surprised, she was surprised in a good way.

Dr. Bailey heard that Meredith was asking her something and she turned to answer. "I am here 'cause one of my five interns randomly decided to code and is about to undergo EPS and maybe needs extensive cardiac surgery including a pacemaker implantation. So it´s kind of my job to be here, to be concerned ... Grey, don´t ever pull a stunt like that again." Bailey told her.

Meredith chuckled at Bailey's insistence.

"I'll try. But my heart is unpredictable, so I cannot promise anything." Meredith chuckled as she looked at Bailey, and then over to Derek. Derek silently pressed her hand to offer silent comfort and she was trying to remember every detail of his face for later when she was having the electrophysiological exam in the cath lab. Derek smiled at her in his dreamy way, Meredith loved that. Dr. Bailey noticed that Derek was smiling at Meredith but when Bailey cleared her throat Meredith turned her attention back to Bailey.

"And Meredith, I want you to tell you whenever you think something is not like it should be, so we can do something about before you collapse or ..." She did not finish her sentence, she did not have to finish it. Meredith knew what the general surgeon meant.

Derek said goodbye to Meredith and gave her a kiss.

"You'll do it, Meredith. I'll wait for you the entire time." Then he turned his face to Dr. Burke, who was seemingly waiting for them to get ready. Derek turned to him.

"And don´t mess this one up, this is the love of my life you know, Dr. Burke." Derek threatened him.

"Don't mess it up."

"I'll try." Dr. Burke replied to the question of the worried neurosurgeon and pushed to the bed. "I love you, Der ... Take care now ... I have faith in them, they will do it. I´ll see you when this is over." Meredith meant and Derek waved, before Dr. Burke released the brakes of her hospital bed and she was rolled by him through the hospital hallway to the cardiac catheterization laboratory.

She was sedated by the responsible anesthesiologist and Dr. Burke started the electrophysiological study (EP study). He made a needle puncture through Meredith' skin and into her blood vessel. He inserted a small straw-sized tube called a sheath into her artery or vein. The doctor gently guided several specialized EP catheters into her blood vessel through the sheath and advanced them to her heart. Dr. Burke, Cristina Yang and the nurses present in the room and the anesthesiologist wore a special lab coat during the catherization, because they are working with in the cardiac catheterization laboratory with X-rays. "In the electrophysiological study, the right heart catheter is used, be placed in the under X-ray control 2 to 4 electrode catheter along the conduction system of the heart. The electrodes placed in the heart serve as a stimulating and recording electrode. With their help, heart rhythm disorders can directly provoked and its cause are located. In addition, the EPU allows the evaluation of impulse formation that makes the sinus node electrode, the excitation forwarding to the chambers of the heart that does the so-called AV node electrode and the line quality. "

"I know." Meredith replied nervously.

"Meredith, you can do this." Cristina smiled an awkward smile. She knew her friend was scared, she was too.

"I know. It's not like I have a choice in that matter." Meredith added. "SO LET'S GET THIS SHOW ON THE ROAD." Meredith exclaimed fake happily. Cristina just looked at her without saying anything.

"The unprovoked during the EP study Cardiac arrhythmias are more uncomfortable. Symptoms are malaise, sweating, palpitations, retrosternal pain or syncope." Burke told her as he guided the sheath through to her heart." Dr. Burke, I know, I'm a doctor." Meredith grumbled as she tried to relax.

"You do not have to be nervous. I've done this before." Dr. Preston Burke tried to calm down his patient. After local anesthesia, Dr. Burke led the catheter into a vein in the meantime a, the catheter is advanced through the inferior vena cava to the right atrium and the right ventricle, the location is first checked by fluoroscopy. At various points in the heart, the ECG is recorded. "I know you've done this before. I may be a patient but I am not an idiot. But that doesn't mean I have to like it." Meredith said in an annoyed tone that was clearly indicating that she wasn't happy with the role reversal of patient/doctor. She liked this more as a doctor.

When the first rhythm disturbances hit Meredith, she pressed her teeth together.

She hated that burning sensation. At first, she was feeling okay considering her current position but after a while she deteriorated. It was way harder to keep her eyes open and even with the sedation that's supposed to keep her calm, she felt more and more panicked. At first everything was going okay but that quickly changed. There were AV blocks. They disturbing signals were coming from there. Meredith tried to relax but breathing became more and more difficult. The produced arrhythmias were visibly uncomfortable for her. "Ahh, here they are." Dr. Burke said, after a glance at the monitor. The multipolar catheters were placed on different places. The one he was watching, was the His- Bundle signal. To get that kind of signal he moved the catheter first into the right ventricle, then he pushed in the direction of atrial back up next to the ventricle also atrial signal appears. Then he had to turn the catheter dorsally, so between the two signals, the His-bundle signal appears. It developed as expected, a pathological arrhythmia, which he recognized as AV block.

Her heartbeat was way too slow. "Dr. Burke. I ..." Meredith came out in panic. Her heart wasn't beating the way it's supposed to, resulting in her gasping in fear for air in fear. The lack of oxygen getting to her brain prevented her from being able to think straight. She was panicking. Adrenaline rushed through her veins but there was no use. "I … I can't …" She had the sensation of not being able to breathe. Meredith felt her heart seemingly slowing down at a rapid rate. She couldn't breathe. Meredith was desperately trying to catch her breath, looked around in panic. Dr. Burke had now noticed that the condition of his patient had extremely deteriorated. "Meredith, stay with me, stay with me, don't do anything stupid." he said to his patient. No Reply. A piercing beeping rang through the room. Then it all went black. "Damn it, she's having AV blocks second and third degree." He exclaimed. In the cardiac catheterization laboratory, there was just hectic, Dr. Burke began to stop the arrhythmias that were now affecting the well-being of his patient, immediately and succeeded.

Meredith's heartbeat returned to normal or a semi normal rhythm. Dr. Burke relaxed again and looked back at the screen. After another hour passed, he'd finished the study and Meredith was ready to be moved back to her room. Then he and Cristina had to go inform Derek about Meredith. They had to tell him about her losing consciousness due to an AV block that was triggered. When Derek saw the heart surgeon and the intern walking toward him, he jumped up from his chair, hoping they had good news. But somehow, Burke's face expression was a bit solemn. His heart was beating erratically in his chest, out of fear. This couldn't mean anything good. Not at all could it mean anything even remotely good. Mark was there too, to support Derek.

"How did it go?" That was Derek's first question. "First of all, Grey is completely stable. But something happened." Burke told him and watched Derek's demeanor change almost immediately. He paled at the mention of possible complications. We got her heart rhythm back to normal after a short time. It was triggered." But apparently, Derek only heard the first part … that something has happened. No, no, no – Derek did not want to believe it. This wasn't happening.

"What do you mean, there were complications?" Derek asked hysterically. Burke and Yang just finished the electrophysiological exam on Meredith. But apparently, something unexpected had happened. "Derek, she is completely stable and back in her room at cardiac intensive care unit. She'll be awake soon."

"You know anything about her arrhythmias?"

"I haven't gotten around to evaluating the results just yet. I will let you and Grey know about the results as soon as I have more concrete information." Derek nodded resigned. Mark put a strong hand on Derek's shoulder while saying: "Let's go see Grey to see for you that she is indeed okay." Derek nodded silently as he let Mark guide him to Meredith's room. When she saw her pale face, and the IVs sticking out of her, he turned around. He couldn't face all that. "Derek, you okay?" Mark asked worriedly. Derek turned around again. "I just … needed a moment." Mark didn't respond, instead, he stayed silent. Then he asked: "Do you wanna tell me?" Derek breathed in deeply. He would have to talk about it sometime, if he doesn't it would eat him alive. "Mark, she could die in that surgery. She could die. There are all sorts of complications that can happen. I'm scared to lose her, all the time and every second of every day."

Mark didn't really respond.

Later that day, Burke had been reviewing Meredith's test results and grew more and more worried. He then decided to talk to Cristina since she was with him on this case. Meredith needed the intern with the most experience in cardiothoracics and that was Cristina Yang. He found her in the gallery where she was making notes and studying. He saw a medical book lay around there. "Yang, I need to talk to you." Burke said suddenly. Cristina's head shot up. From his face expression, she could tell that it wasn't good news. "To talk about the studies we did on Meredith?" Cristina asked back. Burke nodded surprised that Cristina had taken up the hint. "Yeah, about Meredith's rest results …" "Let me guess. They are concerning, right?" Cristina didn't need an answer. Silence was answer enough. Why does it always have to be Meredith? Just why … Cristina stayed composed but she needed a few moments to regain composure. Burke knew her, watching her as she took a deep breath and another one. "It'll be okay. It'll be okay." He repeated those words like a soft lullaby. Cristina was grateful for that, although she knew Burke wasn't big with emotions.

* * *

After Meredith was back in her room in Cardiac Intensive Care Unit, where she will be monitored the whole time, until they were able to perform the life-saving heart surgery, Derek was already waiting for her. He was waiting for the sedative to wear off. Cristina and Burke were both gone, they were discussing the results of the study. Derek sat next Meredith's bed and was holding her hand. Suddenly, she stirred and Derek was more alert on what she was doing. Sedative was wearing off.

"Meredith?"

He asked. Meredith opened her eyes a little bit. She has to go on bypass again when they replace her aortic valve. "So, I am coming with some findings about your arrhythmias, Dr. Grey." Dr. Preston Burke announced as he entered his patient´s room.

Derek was there and Cristina was half- sitting and half- lying position on a visitors' chair next to Meredith's bed.

"Are those the results of her long-term ECG when she had those migraines?" Derek asked.

Dr. Burke nodded and pressed his lips together.

Meredith concluded that the results weren't that good, but kind of already expected that the results wouldn't be that good considering everything that happened. "So, just tell me straight out that my heart is failing, that I need a transplant."

What on earth had caused her to jump to the worst possible conclusion?

Cristina stared at dumbfounded. Of course Meredith was envisioning a horror scenario. She should have known that. Dr. Preston Burke was the first to respond. Derek hoped that her heart wasn't failing. That would mean endless hospital stays and waiting for a transplant if any other treatment options failed ... so please let it not be that. He was pleading silently that it was just the problem with the valve and not congestive heart failure. That would be a lot more difficult to deal with. Meredith glanced over to Derek. She saw the horror that was written on her face.

"Grey, we aren't there yet. First of, your heart isn't failing. And even if it is failing, there are ways to treat this condition, there are also ways to prevent it getting worse or at least that it doesn't worse over the months. And if all this does not help there is always the possibility of getting on a transplant list and we can support your heart muscle with different kinds of ..." He tried to explain, but Meredith did not seem to listen. She just stared at the wall, ignoring everything else in this room ...

Then, she started listing off things that could help to bridge the time to transplant.

Bridging to transplant.

VAD.

ECMO.

ECLS.

These were all options.

"Extracorporal life Support, extracorporal membrane oxygenation, ventricular assist devices ... Yeah, I know, I've seen it before. Denny. He was connected to an LVAD. What did it get him? He was forced to stay in bed, waiting for a transplant and in the end he died even though he got a heart. I don´t know if I want that. Suffering and then I am dying though I got a new heart. And it is as sure as hell isn't easy for relatives and friends. It makes them so desperate that they end up cutting LVAD wires. This point will come at some point, I can feel it. So just tell me: it is failing ..."

"You did not listen, Mer. You heart isn't failing. Stop saying that you'll die, because that is not true. You wont die anytime soon, Mer. I won't let you and I am pretty sure McDreamy here agrees with me on this one, right Shepherd?" Cristina interrupted her person, her voice loud and certain so that she won´t say that she will die anytime soon. Derek nodded, but did not say anything. "So stop the hell saying that you are gonna die anytime soon."

Cristina breathed heavily when she finished her sentence. Meredith still wasn´t very convinced but she did not say anything. Derek squeezed her hand to show her that she wasn´t alone, that she has him being there for her. Meredith returned the pressure with her hand.

"But what if ..."

Derek interrupted her: "Ssshhh, everything is going to be alright. Let him explain. Whatever will happen, we´ll deal with it then. I will be there all the way with you. Just let him explain."

Dr. Burke sighed loudly. This was different than with any other patient 'cause he knew the patient quite well. This was not easy. She did not deserve something like that. She is a great doctor and will make a great surgeon when she finishes her residency just as Cristina. Both of them have the potential to become great surgeons ...

"Your aortic valve is failing but not your heart ..."

Dr. Burke had a hard time reassuring her that her heart wasn't failing as in 'you're in congestive heart failure and need a transplant in order to survive' heart failure. "At least it is not now." Meredith interrupted him a second time. She knew she might need a transplant in the future. She was aware of what could happen.

"Let's just listen what he has to say, Mer." Derek stopped her, his hand was gripping tightly onto her to reassure her that everything would eventually be okay.

"I am listening." She answered, glaring at him.

"Good."

"Can I discuss the results with you now?" He asked firmly, while looking through her patient chart and scribbling something in it.

"Start her on pre-op antibiotics." He ordered quietly towards a nurse who just checked her IV drip. It seemed to function without any problems, which was not that surprising. "Okay, Dr. Burke. I'll start her on them right away." She answered and left hurriedly the patient room.

Meredith nodded, what for a choice did she have anyway?

"But your aortic valve needs replacement, otherwise you will go into heart failure, because it's too much strain on your already damaged heart." Dr. Burke explained carefully. Meredith just stared at the white and sterile walls in Cardiac Intensive Care Unit. Then she said with exhaustion: "There, see. It's what I meant. That is how it begins." She scoffed lightly.

"It's just the beginning. It won´t stay with that, there will come another thing and another ... it is just the beginning. So why don't start with the aortic valve? It's just great. Go ahead." She told them. "Cut me open and whatever you feel like you need to do." That sounded like she'd given up. She clearly did not take the news very well.

Her whole life has been a fight. As a baby she fought hell to survive. Three surgeries. She survived her mother being diagnosed with Alzheimer's. She fought her way through med school, and graduated first. Then she met Derek and that meant more fighting in order to be with him. There have been so hoops she'd been forced to jump through. Addison turning up when she finally thought her life was great at that time, almost getting blown up by a bomb that was in a patient's body cavity, then the appendectomy – she could have easily coded on the table. And now, here she is once again, needing medical attention. All she ever does is fighting over something, for something. This time it was her health.

And she's sick of it.

"You have to decide with which treatment you want to go from here." Burke laid open her treatment options. But he knew as well as Meredith and any other doctor in this room that there was no other option than surgery, not if the stenosis has that far progressed. In Meredith's case, her aortic valve was too far gone for her to be treated with medication. "There is no other option than surgery." Meredith answered, stating the obvious and she rolled her eyes. Dr. Burke proved once more his enormous patience.

"You're right, Meredith but ..." Meredith cut him off once again.

"I know I have to decide what kind of a replacement I want. I know that, believe me, I know. I am a surgical intern and it's my job to know those things."

Bailey bit on her lip in amusement when she saw how Meredith talked to Burke who did not seem affected.

Even Derek held back a laugher.

"For what it's worth, Grey, you've got to hang in there." Dr. Preston Burke answered before continuing to talk about what they hadn't talked about.

"He's right, Grey. You've got to keep fighting. This won't always be like this." Bailey tried as well. Meredith only shook her head. "You don't that, Bailey. Maybe it'll go on like this forever. You know what, this sucks. I am sorry for my poor choice of words but I just have to say it because it does suck big time. All this time, my whole life, my heart condition has determined everything. There were always things I couldn't do because of my condition. Now it's like this again. I feel like I can't do this anymore." "It's been a long road, hasn't it?" Bailey asked, her brown eyes were glancing at her intern. "It has been." Meredith only answered. Derek gripped her hand tightly and squeezed it lightly before looking back at Burke who still had some things to say.

"Meredith, you had several bradycardic phases with a heart rate of less than 40 during the long-term ECG, and while she was unconscious, you had a sinus node arrest, a so-called asystole, and a very long pause before your heart began to beat again. You needs as urgently as possible and immediately a pacemaker!" He told them after they discussed the procedure he will be performing on her. "What?" Derek asked shocked. He had known that there was a possibility of her needing a pacemaker but now that eventually is turning into actually, it is much harder to accept.

She decided to go with the Ross procedure.

"Okay. That was to expect. Of course it would happen to me. Why should it not happen to me?" Resignation was in her voice as she said this. Why does she even bother when every time she enjoys her life something new pops up and shatters it once again? Everyone looked at Meredith when she said those words. "Grey …" Bailey interjected in an unexpectedly soft voice, caring. Meredith sighed. "I know. Is there possibility that we can do both surgeries in one? You know because of recovery time and I don´t really want to go through two heart surgeries within a few weeks. It's just too much. So why don´t see why we can't do both surgeries, my valve procedure and the pacer implantation, all at once?"

She desperately hoped that he would say yes to that suggestion.

"That's a pretty good idea, actually. I am siding with her." Cristina supported her friend. That comment caused Dr. Burke to grin. "Why are you ..." "Are you thinking that I will do the surgery when you side with my patient?" He asked, glancing at Cristina. "Yes." She replied. Meredith tried to hold back a laugher. She absolutely loved Cristina´s sassiness towards other people. It was funny … sometimes. "But we agree with that kind of approach because opening her up in such a small period of time isn't really ideal and it will most likely put stress on you, Meredith, and everyone else who cares."

They decided to run both surgeries perform together. They wanted to avoid that Meredith chest isn't being sliced open twice within a short time.

"So, this is it?" Meredith asked, as Burke and Bailey left the room. "Isn't it? I have this surgery and then there is one hell of recovery waiting for me." Meredith only saw the hardships coming along with her undergoing that kind of procedure, the pain it would cause her, the pain she'd have to endure …

* * *

**A/N: Thanks for reading this and sorry for the delay. I hope you liked it ... Reviews make me happy.**

**An electrophysiology study (EP test or EP study) is a minimally invasive procedure that tests the electrical conduction system of the heart to assess the electrical activity and conduction pathways of the heart. During EPS, sinus rhythm as well as supraventricular and ventricular arrhythmias of baseline cardiac intervals is recorded. The study is indicated to investigate the cause, location of origin, and best treatment for various abnormal heart rhythms. This type of study is performed by an electrophysiologist and using a single or multiple catheters situated within the heart through a vein or artery.**

**During an EP study, small, thin wire electrodes are inserted through a vein in the groin (or neck, in some cases). The wire electrodes are threaded into the heart, using a special type of_ X-ray, called fluoroscopy. Once in the heart, electrical signals are measured. Electrical signals are sent through the catheter to stimulate the heart tissue to try to initiate the abnormal heart rhythm disturbances for evaluation. There are several ways EP studies may assist in diagnosing heart rhythm abnormalities. An abnormal rhythm may be deliberately stimulated by a doctor during the EP study so that the underlying problem can be identified. Then he mapped the spread of electrical impulses during each beat. This may be done to locate the source of an arrhythmia or abnormal heart beat._**

**_It distinguishes between different modes. Depending on the mode pacemakers are classified with 3 consecutive letters, for example VVI or DDD. The first letter indicates where the stimulation takes place: A = atrium (atrial), V = ventricle (ventricular) or D = dual (in the atrium and ventricle). The second letter indicates where the excitation is derived in the heart (also A, V, D). The third letter indicates whether the pacemaker is inhibited at heart its own action (= I) or whether it is a dual chamber pacemaker atrial action is taken, which triggers a ventricular pacing (= T), or whether both features dual (= D) are possible. Common types are VVI pacemaker (used in patients with chronic atrial fibrillation), AAI pacemaker (used in patients with Sick Sinus Syndrome) and VDD pacemakers ..._**

**_DDD pacing: It first detects the excitement in the right atrium and there's also his ex-stimulation. He also detected in the right ventricle, whether the excitement comes from the atria via the conduction system. If they are not in the set time window, it also stimulates the ventricles. Thus, the DDD pacemaker works relatively physiologically and can be used universally. He thus has a wide range of indications. It is, for example, for security reasons when sick sinus syndrome in question is to be taken in the provision for the case that during the development of heart disease and the AV node is included. In atrial fibrillation, a DDD pacemaker is not an option._**

**_I will try to post the next chapter sooner ... presumably next Tuesday._**


	19. Chapter 19

**Chapter 19**

* * *

**For a surgeon, every patient is a battlefield. They're our terrain. Where we advance, retreat, try to remove all the landmines... And just when you think you've won the battle, made the world safe again. Along comes another landmine. Some wars are never over. Some end in an uneasy truce. Some wars result in complete and total victory. Some wars end with a peace offering. And some wars end in hope... But all these wars are nothing compared to the most frightening war of all. The one you have yet to fight. **Meredith Grey; Life During Wartime

* * *

The next day was the big day. Big day, the very big day. The day she is cut open, her insides are going to be visible for the surgeons who operate on her. And maybe if the gallery isn't closed ... then a bunch of other people stare at her too. And that is what makes her stomach churn. Meredith wasn't very happy about that, being in the OR as a patient and not a doctor but there was nothing she could do about it. She didn't have a choice. And she wanted to live. Without the surgery she would die due to the AV block and at some point the aortic valve would send her heart into congestive heart failure ... So she needed to have the surgery. Derek was worried, Meredith tried to stay calm as Dr. Burke told 'em that her pre - op chest films and lab results were clear and that they were ready to take her down to surgery.

"We are ready to take you to the OR but if you need a minute or two we'll be giving them to you." Burke said, as he winked his team to step back and let Grey have her privacy. "Your pre - op fims came back clear, there is no indication that you have a common cold or anything infectious that will lead to problems during your surgery." He smiled reassuringly at his patient. Derek inhaled deeply, for a moment he closed his eyes. "See you in the OR, Grey." He said before he left the room. "So, now we're alone." Meredith said. "Last moment before surgery." Her voice shook a bit. She still couldn't believe that she really needed open heart surgery in order to stay alive. "Mmm." Derek vaguely answered. "I love you, Derek. I hope you know that." Meredith suddenly said. "You don't think you'll die, right?" Anxiously, he waited for an answer.

"You never know." Was her cryptic answer. "I hope I don't but if, I love you from wherever I am." Meredith almost cried as she said that, her voice quivered dangerously.

"You won't. Don't ever say that again." Derek hoped he sounded strong.

"Okay." Meredith smiled at him.

"In the meantime, try not to do anything stupid." Derek said, lightly teasing his girlfriend. He again looked halfway relaxed. Meredith had sent him home to get some sleep, because after the surgery he will probably spent most nights in the hospital, sitting on her bedside and making sure she was okay in order to sleep through the night before surgery, because it would not be a use to her when he collapses due to lack of sleep ... and eat. Which will be probably be the last thing on his mind as she can think. Derek would be hovering so much that was clear to her.

"So, do not be stubborn and take care for a few hours yourself ..." Meredith told him and squeezed his hand reassuringly. Derek Shepherd smiled weakly. There was no way to describe what he was feeling. Worry. Fear. And a lot of other things too. "It'll all be okay. Dr. Burke has done this a million times. He knows what to do, even if complications arise ..." And lo and behold it had worked. Derek Shepherd aka McDreamy had really listened to Meredith Grey, he had listened which is a huge step forwards. "What do you mean with that? Stupid things. I won't do stupid things." Meredith asked, not knowing what he meant or could possibly mean with that except coding or anything that qualifies as a code. Maybe it's that what he means.

"Also, I'm anesthetized how am I supposed to do stupid things?"

"With stupid things I mean cardiac arrhythmias and suchlike ..." Derek replied with a grin.

"I try not to. But then I will be the proud owner of a little device implanted directly under my collarbone. That stimulates my heartbeat to remind my heart that it has to beat regularly. So no more arrhythmias." Meredith giggled and her heart monitor showed a faster heart rate. "Hopefully I will have a little more energy after the implantation of the pacer. 'Cause then I can do things without getting dizzy or having the feeling that I need to sit down because I am about to faint due to poor circulation or whatever the problem is. Maybe my circulatory attacks will stop too." Meredith rambled, nervously.

Derek traced his thump gently over her cheek causing her to stop.

"I am just saying, don't think of pulling something funny" He replied. Meredith nodded, chuckling. "Oh. Now I do understand." She answered and looked up to Derek, feeling the need to stop the time. To let this moment go on forever without needing open heart surgery to survive. She still hated that and she hated being confined to a bed which she will be for a certain time after open heart surgery. There is no way to escaoe from that and she knew that is was like that. But right now she had a happy moment with her neurosurgeon boyfriend - hopefully soon not only boyfriend but something bigger, maybe fiance.

Meredith laughed, the monitor showed a quicker heart rate. Then Derek gave her a kiss. She replied with another kiss. A long, intense kiss happened between them. Then Derek had to let go Meredith's hand, the entire time had detained.

Then there was a soft knocking on the door and the Chief entered the room.

"Meredith." He said. "I wanted to come by before your surgery and wish you luck for your surgery." Meredith looked at Dr. Webber. This was the right time to ask him for a thing. "I appreciate that. And there is something else I wanted to talk to you about." Derek knew what she wanted to talk about, she had told him and they had talked about it.

"Carry on." He signaled her to go on.

"Could you maybe close the gallery? I dont want people to see me like this if not neccessary. I know it's a lot to ask but could you ..." She didn't finish the sentence and didn't had to finish it. Dr. Richard Webber knew what she asked. And he would do everything to help her. She was like his daughter.

"I just need some dignity." She added quietly, looking at the white sheet she was pulling on.

"I know. I will make sure the gallery is going to be closed." Richard reassured her.

Also, Alex Karev came to wish her good luck for the surgery. Meredith was happy when she saw that he came by. Izzie and George didn't show up. "I know you will do it, Grey." He smiled as he said this. "But I am holding everything up, right?" He said. "No, it's okay, Alex. And thanks. Due to your actions that saved my life I even have the chance to survive. Thank you so much for giving me that." "Well, your like my sister." He just answered. "Blood's thicker than water. I watch out for you and vice versa."

"Right. See you after, Alex."

Then Alex left, Bailey also came by eventually. Then she and Derek were alone for a moment. "I love you, Mer." Derek kissed her and Meredith closed her eyes as he did that. She felt him and smelled his scent and for a moment it was okay. She accepted her fate. "I love you too, Derek. I do. You're my McDreamy. I ..." She smiled. Derek looked broken when he saw Burke and Cristina in the doorstep they were there to take her up to the OR.

"I love you, Mer. Good luck. I'll be waiting for you." He called after her.

Dr. Preston Burke and Cristina Yang brought to Meredith to the OR. Derek felt helpless when he watched Meredith's bed disappearing. He didn't knew it was so hard. It was the hardest thing he had ever done in his life. He choked back tears ... Well, it was really freaking hard. His girlfriend was having major surgery. On her heart. It seemed unbelievable. They had to stop it in order to repair the organ and put her on cardiopulmonary bypass machine. A machine would be pumping her blood through her system for several hours ... Derek was standing in an empty room in Cardiac Intensive Care Unit.

All monitors and devices were turned off, nothing blinked or beeped or made noise in any way. He felt lonely, like there was no one there. Meredith. He couldn´t stand the thought of losing her. A life without her wouldn't be worth living. She has to. Okay, he was driving himself crazy. He has stop. He really needs to think about something else. He was driving himself crazy with all the worst case scenarios ... He's gotta stop right now.

* * *

When Meredith was about to be put under, she grabbed Cristina by her arm. Cristina´s brown eyes were focused on her person. "Yes, Mer." She asked. Meredith swallowed. Then she said, quietly: "You are my person. You´re like my sister, the sister I never had. Remember that." Cristina dawned about what this was. "Mer ... " She said, wondering why Meredith Grey chose this moment to open up. Meredith looked to the side, all the medical devices here, the vent on stand - by, her chest films on the wall, the gallery that was closed but still.

"If something goes wrong, I want you to tell Derek that I love him and wanted to spend my life with him, you know marry him and have his kids ..." Meredith started. Cristina swallowed hardly. No, she can't go under when she thinks she'll die. It may have an influence of the outcome of the surgery.

"You don't have do that." Cristina did not know how to react.

"I do. If I ..." She stopped for a moment and closed her eyes. Then she looked back at Cristina.

"If I die, I will never get the chance to say the things I always wanted to say. I am truly sorry for not saying something before starting my internship here. That was pretty dumb, actually."

"You're right, that was a dumb move from you and you should really shut up." Cristina told her. She was being strong for her. "You won't die. _I _won't let you die after all you put us through. If you do that, I will bring you back to life and then kill you again, so no. Dying isn't an option. So please, Mer, be optimistic about this. I know you're all dark and twisty, but please, for me, be optimistic for once." She begged and pleaded, despair evident in her voice. Meredith glanced at Cristina.

Then she looked around and all she saw was the cold sterile environment, the intruments with them they would be cutting into her flesh to get to her heart. Dividing the sternum and out her on bypass. It seemed like ... she didn't know what is seemed like, everything was just happening and she didn't have a say in it.

"I am scared." Meredith suddenly confessed, in a rare moment of vulnerability. "I don't want the surgery."

Of course she didn't want to have the surgery, nobody wants to have open heart surgery at least not on their free will.

"I know. But you have to ..." Cristina trailed off.

"I will see you after the surgery." Meredith's voice suddenly changed to confident.

"That's the right arritude." Cristina answered. Meredith smiled and Cristina gave the gas man a wink that the patient was ready to be put under. The anasthesiologist began with his work. He injected the anaesthetics. Meredith's eyes slowly closed and soon she was put under. Cristina felt the grip of Meredith's hand on her arm loosen. The anasthesiologist started with the whole airway management and intubated her. Cristina left the operating room and returned to the scrub room where she met Dr. Burke who was washing himself sterile. Cristina followed his example. After that they entered the OR. "Is she prepped and ready?" He asked the anaesthesiologist who nodded in response.

"Good." He simply replied.

"Let's start." Dr. Burke announced. "She's ready, you can begin." The cardiovascular perfusionist answered quickly and sat down in front of it to set it right. "Scalpel." Dr. Burke said made the first cut. When they finished opening Meredith' chest, Dr. Burke wanted the sternal saw to divide the sternum to provide direct access to your heart. Now it was time for stopping her heart and let the machine take over heart function as well as lung function and temperature regulation.

"So, let's cool her down to 28°C." Dr. Burke said.

Cristina nodded in understanding.

Meredith was cooled down to 25-28 °C. As a result, the oxygen requirement of the body is decreased and ischemic tolerance time of the myocardium goes up. Anticoagulation is essential as the blood during the bypass in communicating with foreign surface. It is administered heparin that is antagonized with protamine at the end of the surgery ... The heart is still beating since the coronary arteries were still perfused. Multiple cannulae are sewn into the patient's body in a variety of locations, depending on the type of surgery.

A venous cannula removes oxygen deprived blood from a patient's body. An arterial cannula is sewn into a patient's body and is used to infuse oxygen-rich blood. A cardioplegia cannula is sewn into the heart to deliver a cardioplegia solution to cause the heart to stop beating.

But then: "Now we do what?" He asked Cristina. She should be learning something today.

"The aorta is clamped proximal to the aortic cannula and because of that the aorta receives no more blood." She answered, looked at him, then back at the 's heart. The heart of her person. It seemed almost unimaginable.

Wow, she thought. This was Meredith's heart. The heart that had kept her alive for twenty nine years. Although it was malformed. Is malformed. It wasn't a corrective procedure they did. It was palliative. Not a cure. It wasn't a curative surgery, it was a palliative surgery. Palliative surgery related to pediatric cardiology means giving the child a shot to live with one or more steps. Fontan procedure, what surgeons perform on HLHS babies or babies with any other kind of single ventricle defects, is a palliative procedure too. You can't corect a hypoplastic ventricle. That's impossible. Cristina knew it.

"Good. I am going to crossclamp the aorta and then inject the Dr. Burke said injected the cardioplegia solution directly into the aortic root. It contains inter alia magnesium, potassium and buffer substances and is used as cardioprotection. It administered intraoperatively every 20-30 min again.

They then connected the arterial and venous cannula into the heart and into the aorta and the pulmonary veins inserted so that they are connected via with plastic tubes to the cardiopulmonary bypass machine. "She is on bypass now the fun part begins." Cristina glanced at him disaprovingly

"Okay, I open the left ventricular apex." He said concentrated.

Cristina was once again fascinated by what she saw.

Then she looked up to the gallery. Dr. Webber closed it for the regular staff. But she saw one person sitting there. Dr. Bailey. She was watching everything. "Cristina, focus- " Dr. Burke told her without taking his gaze from the heart he was operating on. "Yes, Dr. Burke. I am focusing." Cristina quickly refocused on the surgical field. There is no way she wants to endanger Meredith's life by being not focused on what she was doing. They were doing a Ross procedure. First step was measurement of the aortic and pulmonic valve. "Yeah." Cristina answered and started watching Dr. Burke measure the valves.

"Okay, we are done with measurement of the valves, everythings looks fine to me. I am moving the next step. Which is, Yang?" The cardiac surgeon asked the intern next to him. "The aorta and pulmonary artery are opened and the aortic and pulmonary valves are carefully inspected to determine if the Ross is an appropriate procedure." Cristina answered. "Good, we start opening the aorta and pulmonary artery." After that, Dr. Burke removed in small, precise moves the diseased aortic valve. Then, he carefully removed the pulmonary valve (autograft) and placed in the aortic position. Cristina watched in awe, she totally forgot who the patient was but maybe that was for the better. This was brilliant. Fascinating. There were no words for it.

"Are you watching?" Dr. Burke asked without looking out.

Of course she was.

"You bet I am." Cristina replied, not taking her eyes off the surgical field.

The autograft in sutured in place and the coronary arteries are pulmonary autograft is placed in the aortic position and the buttons of tissue on both the right and left coronary arteries are then sewn into that pulmonary segment and closed. A cadaveric pulmonary valve and artery homograft is then replaced in the pulmonary position to replace the excised pulmonary segment. A pulmonary homograft is attached to the right ventricle outflow tract. The aorta is attached to the autograft and the pulmonary artery is attached to the homograft - the procedure is complete.

While they were operating, Dr. Bailey was sitting in the gallery. She watched the whole procedure. She finished a bunch of patient charts. It seemed like she called off all her surgeries for today now she was just watching Meredith's surgery. Derek knew she was watching it and every time she left the gallery he was asking to get an update. Dr. Bailey looked at her watch.

It was time for an update. She sighed and left the gallery to find Derek Shepherd. Then they were ready to place the pacemaker. The last step before closing her up.

* * *

Derek couldn't take it anymore. He needs something to distract him. He paced up and down the halls of this hospital until he was tired of waiting and waiting and waiting. "Derek?" Someone behind him called his name. Deep in thoughts about Meredith he turned around and saw Dr. Miranda Bailey standing there, in her arms a bunch of what looked like a lot she could give him an update. Maybe she could. Derek held his breath as he anxiously waited for her to continue.

"I am here to give you an update. I know the closed the gallery but Dr. Webber allowed that I see how it's going and give you updates in regular intervals. So here I am, giving you the, as I can see, desperately needed update on Meredith's condition - could you please stop pacing? It's annoying." She asked him, in friendly way.

Derek stopped for a moment and asked a single question: "How is she?"

"They are about to remove the aortic valve and replace it with the pulmonic valve. They´re doing a pretty damn amazing job." Derek smiled, but still seemed 's brow furrowed as she watched the neurosurgeon.

"Hey, it's going great. You have nothing to worry about."

"It's not only the surgery I worry about. It's also the recovery. She has her chest being sliced open, her ribs being pulled back, the sternum divided in two - she's gonna be in a great amount of pain when she wakes up. It is not just the surgery." He sighed loudly, he was unable to express his true feeling about it.

"And then the amount of time she is going to be on CPB. I mean, things are going to be hard for her after her surgery. Maybe I should take time off. It's the right thing to do." He said, not really asking.

He already decided.

The Chief would understand.

"Maybe you should." Dr. Bailey only confirmed his opinion.

"You're right. I will go ... see the chief and have a very uncomfortable conversation with him." He answered and turned to go. Distracted, he turned after a few meters to Bailey and said: "Thanks ... for the update."

"No problem."

Then he made his way to the chief's office. He knocked on the door, waiting for Dr. Webber to call him in. When he did, he slowly opened the door and entered the room. "Derek." The chief said surprised, obviously he didn't expect him here. "I did not expect to see you here. Aren't you supposed to be waiting on news?" He asked.

"I need some time off." Derek said abruptly.

Dr. Richard Webber just looked at him, his eyes were fixated on Derek's eyes. He knew why he was asking for time off but he wanted to hear it from him. "Why are you asking for some time off?" He asked and he put down the pencil on the wooden table that was covered with papers, the computer, patient files and some literature about general surgery. "You know the answer, don't you?" Derek just replied. "I do." Dr. Webber paused and after a few seconds he continued with talking: "I do know the reason why you´re asking for some time off. But I want to hear it from you."

Dr. Webber glanced expectantly at his world- class neurosurgeons who was sitting opposite to him. Derek sighed loudly, his thoughts were circling around the question how Meredith is doing.

"I need to take a leave of absence, because I want to be there for Dr. Grey, you know. Recovery´s not going to be easy on her, in fact it is going to be painful and hard- and I would see myself as a complete ass if I didn't take some time off to help her get through it. I would want the same thing if I were in her position. So, Richard, as the chief of surgery and my friend, I´d greatly appreciate it if you sign off on me taking a leave of absence." Derek finished his speech and leaned back in his chair. "How long?" Dr. Webber only asked one question.

"Probably as long as her recovery takes. So that makes at least three weeks, minimum." Does that sound realistic when talking about recovery after open heart surgery? He didn't know. If it were brain surgery, yes, but cardio? Cardio had never been his thing. How is he supposed to know? How is he? He has never done something like that before, at least not as a family member. With any other patient, there wouldn't be a problem. But this was Meredith, his Meredith. He just couldn´t keep the distance, not as a doctor should.

As of now, he knew why doctors don't treat family. It would lead right to the situation he was in, also judgment is clouded when it comes to treating family. So, enough about why doctors shouldn´t treat family, looks like he got off the subject … Dr. Webber inhaled sharply. "Five weeks is a long time, Derek." He said, sighing. He didn't like the direction this conversation was taking at all. With Meredith being sick and Derek on leave they were short two doctors. But he also cared about Meredith so he appreciated that Derek wants to do everything to help her.

"You think I don't know that? I do. These weeks post-op aren't going to be anywhere near easy for …" He stopped in the middle of his sentence, trying to cool down, to keep his anger and needless to say, worry in place. Dr. Webber knew this man was just worried about his girlfriend who was having a risky heart procedure and didn't mean to say all of this. He didn´t take the things Derek said seriously. Derek's gaze wandered through the room, stopping at the clock on the wall. He was nervous, he had almost completely forgotten that Meredith was still in surgery. Otherwise he would have been paged. He made Dr. Burke promise he would page him as soon as they were finished. "Sorry for the yelling. That was unprofessional and I apologize for doing it." He later on apologized. Dr. Webber nodded.

"It's okay, Derek. You have nothing to worry about." He answered.

Derek continued with his sentence: "It's not. But I also think that the hospital can and will survive without me working and performing all the procedures I dreamed of. Not just routine, I mean fancy, experimental procedures. I will go back to that activity as soon as Meredith is about to start working here. But for now I will focus on Meredith getting better sooner rather than later." Dr. Richard Webber started chuckling. "You are kind of rambling." He said. "Meredith's rambling seems to have influenced you." Derek did not respond to the comment.

"Instead of doing all these fancy experimental procedures I will help Mer through her recovery. I was raised to be there when my family needs me. We help each other to get through a hard time. Currently, Meredith is facing a particularly difficult and tough time. And, she is my family. Besides Mark my only family on the west coast. She needs me, even if she´s too proud to admit it." He finished his inspiring speech.

Dr. Webber slowly nodded.

"I'll give you five weeks off." He finally agreed. Derek had to hold himself back so he wouldn't call out yes in front of the chief. But he was relieved that the chief granted him three weeks of leave. Derek stood up to shake hands with the chief of surgery. "Thank you very much, Dr. Webber, for giving me time off when I needed to." "No need for thanking me, Derek. I am happy that you want to take care of Ellis's little girl. I would have given you time off even if you hadn't asked."

"Thank you so much. I don't know what to say, I am at loss of words because of the kindness you have been showing towards me, and for approving my relationship with her." Derek looked Richard in the eye and showed a small hint of a smile that was soon replaced with worry. "I should go find Dr. Bailey. She's been giving me updates on her condition every hour." When he was about to leave the room, Dr. Webber called him back. Derek waited for him to say something.

"You really like her, don't you?"

Derek smiled when he pictured Meredith and replied: "I love her, as in I want to spend the rest of my life, every second of my life with her and marry her and have her kids. That´s the way I feel about her. She´s more than just a flirt, she is the love of my life. I love her, Richard. I would do anything for her."

"Good. I just wanted to make sure you know what you want." He sounded as a proud father who wanted nothing more than to protect his child. "I want her to be healthy, Richard. She's a good person, she doesn't deserve this." Derek sighed and buried his head in his hands. He was worried. "I know." He sighed. Then he grabbed a pencil, Derek assumed he had paperwork to do and left his office. He found himself staring at the OR rotation where was written in neat letters with black sharpie: **Grey, Meredith; aortic valve replacement + pacer implantation; OR 1; Surgeon: Burke, Preston; Intern assisting: Yang, Cristina.**

Derek couldn't look away from what was written there. It made everything so damn real and he didn't want it to be real. This shouldn't even be real, this shouldn't be happening at all. Meredith was a doctor, a damn good, a great surgeon/ doctor. She wasn't supposed to be a patient. She should be the assisting intern on his neuro cases. He needed her - at work and in his private life. She was his everything. Meredith was all he wanted. Without her he wouldn't be happy ... Mark somehow found him, staring at the board. "Hey, Shep." He called, seeing Derek glancing at the OR rotation.

"Derek." He nudged his best friend's shoulder. "I am sure she'll be just fine."

Mark Sloan wanted to say comforting words to his brother. "I am sure she will be okay. Burke is the best. She is in great hands even if something unforeseeable happens ..." Derek nodded and tried to say something in return but he wasn't able to form any words. As if he was frozen ... "Come with me." Mark said and led the neurosurgeon past the staring and whispering nurses and other medical personnel. "The show's over, guys." Mark called over the shoulder and tossed them an angry view.

* * *

"What am I gonna do with you?" Addison Montgomery asked aloud while she gazed at the three interns standing in front of her. "Why are we here?" Izzie asked. "We all know Meredith is in surgery right now. We have been paged." They were waiting for intructions coming from her. But so far, nothing. "Are we going to just stand here and do nothing?" Alex asked annoyed. "Can I at least go up to peds, see if Robbins needs a hand. At least then I would be doing something much more useful than just waiting and standing here." He suggested, obviously eager to get in on a peds case. He was but he also wanted to keep his mind of Meredith. Before Addison could say something, Izzie spoke up.

"How can you even think about working right now? How can you not care about the fact that Meredith, one of our own, is in OR 1 right now and being cut open? Are you really that damaged, evil spawn?" Izzie glared at him. Alex was stunned but not in a positive way. In a bad way. Negative way. Izzie Stevens really had the nerve to point with a finger at him? She was the one who acted that irresponsible what almost cost her life and she really had the nerve to point at him of all people. He was the one who saved her. _**Him**_. Not her, Alex had saved her. Together with Mark Sloan.

For second, Alex was silent, he let the words sink in. Then, he exploded. He turned to Izzie, he had an angry and hurt expression on his face.

_How could she say this to me?_

_She doesn't know me, as a colleague, yes, but not in personal life._

_She is the one who screwed up, not me. Why is she turning this on me?_

_She is the one to blame. I did not make her run for the hills with a comment. That was her. Her._

_Not me. She has no friggin' right to say that._

"Don't you dare saying that, Stevens." He growled.

"Stop, both of you stop." Addison intervened. But nor Izzie or Alex seemed to care. Izzie started to protest, but Alex cut her off: "I wasn't the one that sent her running for the hills with a stupid comment and caused her to endanger her life. That was not me. That was _**you**_." His voice was sharp and implacable. His face expression was grim. Very grim.

Izzie had tears welling up in her eyes. "I don't wanted it to go that way."

Alex scoffed absentmindedly. Worry was in his eyes.

George stared between them back and forth. They really have picked a great day for a shouting match. "I didn't want it to go that way." He mimiced her in a voice that showed that this was a lame excuse. "Well, look where it got you. And her. She would be dead if Mark and I hadn't found her in time. As in real dead, like going to morgue- dead." Alex shot a look at Izzie. "Just for the record, I do care about her. She´s like my better half or something. If I were you, Izzie, I wouldn't hang myself too far out of the window. I'd watch out if I were you." He spat.

"And you want to call me evil spawn. Fine. I am fine with it. Do it if it helps you sleep at night. But let me tell you something: I had a crappy life, crappy childhood and I have learned to accept the crap things life throws at me. Even if it means your stupid comments. I can live with that. But at least, I made something good come out of it. So I am just saying you don't know me. Not the real me. You just know cocky Alex. Meredith sees me, sees who I really am. Yang accepted me too. So, whatever, call me evil spawn if you want to." He told them. "I don't need you, Izzie. I really don't. Look for another charity case ..."

Izzie and George stared at him with wide - opened mouths, gazing at him.

"I need to leave. Can I get my assignment now? I'd really appreciate it." He asked Addison. "You're on peds. Now go. You have done enough. Now isn't the right place for placing blame, Karev." Addison tried to explain. He huffed and without another word towards Addison or Izzie or George he stormed away, mumbling to himself: "Now, I will get myself a nice peds case."

* * *

The procedure is performed by an approximately 4 cm long incision below the collarbone but since they had done a total sternotomy it was not necessary. The to be implanted probes were introduced by Dr. Burke either under direct vision into a superficial vein (cephalic vein) or alternatively after puncture, without direct line of sight, in the vein located behind the clavicle (subclavian vein). Under control by an X-ray machine then one or two electrodes are advanced to the heart. Dr. Burke placed an electrode in the right ventricle and, optionally, a second in the right atrium of the heart. Over these probes Dr. Burke implanted the pacemaker to monitor the heart rhythm and possibly stimulate the ventricles if needed.

After Dr. Burke had loosened the aortic clamp, he and Cristina were patiently waiting for the heart takes up its work again. The heart begins to beat again only when after removing the aortic clamp and the myocardium gets perfused with blood again and thus can build a normal membrane potential. Either take the heart's rhythmic the heart takes up its work again. The heart begins to beat again only when removing the aortic clamp and the myocardium gets perfused with blood spontaneous activity are again on electrically or it must.

Impatiently Cristina looked at the timer. In the further course, blood and body temperature will be warmed up slow and gradual and parallel with that, the power of the CPB will be slowed down and then will be stopped altogether. Either the heart takes up its activity spontaneously on its own or it won´t so that it will need to be *reminded* that it has to start working again?

Then, finally, they could take Meredith off the bypass machine and stop the machine now. The perfusionist pressed a button and the machine rotated slowly and after a few minutes it stopped. "Let's see if the heart starts beating on its own, or whether we have to help." Cristina hoped heart would start beating on its own. Transfixed she stared at the heart and waited. For a heartbeat. "Come on, Mer." Cristina whispered. As if in trance she saw how Dr. Burke called for the internal paddles. "Charge on 300 and clear." Then he looked at the monitor.

_Peep. Peep. Peep._

They had a sinus rhythm, heart beat again in time. They had a rhythm. The ventricles and atria had started to contract, pumping blood through the system and back to the lungs. Cristina breathed a sigh of relieve and looked incessantly at the monitor, where became apparent heart beats and enjoyed for a brief moment the steady beeping. Her heart was contracting.

* * *

Derek ran around nervously on the hospital corridor. It felt as if were seconds minutes and minutes were hours ... It simply unbearable. Like a caged tiger, he ran back and forth, constantly tossed glances at the clock, but the clock did not seem to want to move. Mark, who is about to tell Derek that he should just stop with the running around, 'cause it was becoming pretty annoying ... Yes, he was worried about Meredith and he gets that but does he really have to be like that?

"Derek, it will be all right And the catheter will last as long as it will last We have no influence." Mark, who is about to tell Derek that he should just stop with looked at his friend encouragingly, adding: " You can do that, it is strong" Derek nodded and stopped the running around for a few minutes and now leaned against the wall. "We will move her back to Cardiac Intensive Care Unit as soon as she´s stable and until the anesthesia wears off she´ll be in recovery and later on moved." Burke told him.

The surgery went smoothly, there were no complications or anything like that. She is gonna be fine, which is a true relief for Cristina. It was the most important surgery she ever scrubbed in. After 6.5 hours, the surgery was completed, however, the anticoagulants could not be discontinued, hthey had been given to her for the time Meredith spent on the CPB, After several hours, Dr. Burke and Cristina came up to Derek who was waiting impatiently on any news. He got updates from Dr. Bailey who was watching the entire procedure. That helped but he really wanted to know for sure that everything was going to be okay ... Behind them they saw two nurses bed with the anesthetized Meredith pushing down into the hallway to recovery.

Quickly, Derek rushed up to her, but was held back by Cristina Yang, who was looking, well, she kind of was smirking. She was happy, maybe that could mean everything went smoothly and without complications? "You take her back to Cardiac Intensive Care Unit as soon as the anaesthesia wears off. Then we´ll see if we can move her to CICU." She said quickly.

Derek looked at her hopefully, in his eyes could be seen hope but also the fear that the Ross procedure did not work or there were complications during implantation of heart pacemaker or heart valves Cristina could no longer contain herself, she had to smile, because she was so happy that they would now have heart rhythm disturbances are controlled. The _Schrittie_ would ensure that something like in the last days would not happen again. "Cristina, now talk to me." Derek urged the young doctor impatiently.

Thereupon Cristina calmed and began to explain.

"Well, it went well." Derek was relieved, at least one less worry. He hoped that Meredith would recover soon. "Were there complications?" Derek wanted to know, needed to know and luckily Cristina shook her head. Relief flooded through his body, his neck straighthened. "No, the oeration went as planned and at the moment everything looks good. However, we have to wait until she wakes up before we can say something concrete." Cristina said afterwards. Derek looked to Dr. Burke, who was standing a few feet away and had performed the operation.

"Can I see her?" Derek asked, hoping he will give his approval.

"When Grey's back in Cardiac Intensive Care Unit. Right now, she is still in recovery. When she's moved we'll let you know via pager. Then you will be able to see her." Dr. Burke answered.

"Come on. Please, let me see her." He tried to negotiate. Mark suddenly appeared behind him: "Shep, let the man do his job. She´ll be out of recovery soon and then you can sit with her. Let´s get you something to eat." "He is right. Listen to the man." Dr. Bailey joined the conversation. "You make sure she is okay." That were his last words before he headed to the cafeteria to grab water and some food before he finally could go and see Meredith.

* * *

_After a few hours: _When they allowed him to see Meredith, she´s already been transferred from recovery to Cardiac Intensive Care Unit. He wanted to be strong, but certainly he wasn't prepared for this. Seeing a loved one suffering, lying in the Cardiac Intensive Care Unit surrounded by all sorts of medical devices that were recording saturation, pulse, blood oxygen, blood pressure, heart rhythm et cetera. But there was one thing he was happy about, or more relieved. She is breathing on her own. They were able to wean her off before taking away sedation. There was a ventilator on stand - by but now she just needed extra oxygen over a nasal cannula. She had needed a mask before that covering mouth and nose but right now there was just the nasal cannula.

The cardiac monitor beeped regularly, signaling a normal sinus rhythm. A sinus rhythm. She had retained her sinus rhythm she was lucky that was 'cause Burke had told them that she might lose her sinus rhythm completely once the pacer does give the electric signals for the conduction system. Everything was quiet besides the noises coming from the monitors. Derek looked at Meredith with his McDreamy eyes. Despite all the wires and tubes she was attached to, he could still see her face. Meredith's eyes were closed. "Sleeping beauty." He whispered although it was more than likely that she would wake up anytime soon. Like, next second or something.

His complete attention was locked onto Meredith.

And only Meredith Grey.

Derek released a deep breath as he reached for Meredith's hand. Her hand was cold. She's had always cold hands due to poor circulation and oxygenation of her blood due to the congenital heart defect which was the reason for them to be here suffering through all of this mess, he reminded himself, this is nothing to worry about. She was still here. She was alive, they got her breathing on her own and soon she would wake up, he hoped. But still, she did not exactly look like the Meredith he got to know in the first months into her internship ... it was to expect. Everything went perfect, he reminded himself but he couldn't take his eyes off her pale face and her messy hair. And the chest tubes that drain the amount of fluid building up in her chest. The surgical incision was covered, so he couldn't see the scar it would be leaving.

Yes, there was a scar before the surgery but because of the surgery ... the scar became more conspicuous than it already was. But it was one of the things that doesn't matter. She is still breathtakingly beautiful and he couldn't imagine himself with another woman that isn't Meredith. Meredith Grey is his one and only.

Derek watched her sleep, recovering from major surgery. He tried to stop thinking about the weeks of pain she was facing. Her chest rose and fell almost imperceptibly. "Is she awake?" A quiet voice asked when entering the room and slowly closed the door behind her. Cristina was studying the monitors and looked through her patient chart. "Not yet." Derek replied, his eyes focused on Meredith. Not wanting to miss a breath. "It takes time. She just needs time. But she'll come back, she is way to stubborn not to come back." She chuckled slightly. "Respiratory rate is almost normal, as are her pulse and blood pressure. On this stage I'd say, it's a pretty good outcome."

"But she hasn't woken up." Derek demurred worriedly.

He was worried to death about her. Now. Before and he will.

"She will."

Come on, Mer, I know you can do it. Open your eyes for me. Derek pleaded silently. After Cristina left the room, he continued to stare at the monitors. Tracing his fingers over her arm, careful to not press on her i. v. access.

Suddenly, Meredith stirred. Slightly, but she did actually move.

Derek's eyes were fixated on her face. She was waking up. Then her eyes fluttered open. Slowly. "Mer." He got out. He softly squeezed her hand. When she started moving a bit more, she let out a small moan. The room and the person in it, holding her hand, were still blurry. After she squinted a few times she could make out Derek sitting by her bedside and holding her hand. Hovering above her ...

Then she heard his voice: "Hey, sweetie. Welcome back."

She smiled weakly and gently squeezed his and to show him that she understood what he said. She heard him whisper "I love you more than anything, Mer." It was hard to stay awake for long, so she felt the sudden need to just close her eyes and sleep. Maybe that was from the blood loss. Every surgery goes along with a loss of a certain amount of blood.

"Love ya." Barely audible, she mumbled the words as she drifted off into a nice healing sleep ... Derek smiled.

* * *

_**A/N: So, that is the nineteenth chapter. I hope you liked it ...**_

_**Cardiopulmonary bypass can be defined as: bypass of the heart and lungs as in open heart surgery. Blood returning to the heart is diverted through a heart-lung machine (a pump-oxygenator) before returning it to the arterial circulation. The machine does the work both of the heart (pump blood) and the lungs (supply oxygen to red blood cells).**_

_**Cardiopulmonary bypass (CPB) is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body. The CPB pump itself is often referred to as a heart-lung machine or "the pump". Cardiopulmonary bypass pumps are operated by perfusionists in association with surgeons who connect the pump to the patient's body. CPB is a form of extracorporeal circulation. Cardiopulmonary bypass is commonly used in heart surgery because of the difficulty of operating on the beating heart. Operations requiring the opening of the chambers of the heart require the use of CPB to support the circulation during that period.**_

_**CPB mechanically circulates and oxygenates blood for the body while bypassing the heart and lungs. It uses a heart-lung machine to maintain perfusion to other body organs and tissues while the surgeon works in a bloodless surgical field. The surgeon places a cannula in right atrium, vena cava, or femoral vein to withdraw blood from the body. The cannula is connected to tubing filled with isotonic crystalloid solution. Venous blood that is removed from the body by the cannula is filtered, cooled or warmed, oxygenated, and then returned to the body. The cannula used to return oxygenated blood is usually inserted in the ascending aorta, but it may be inserted in the femoral artery. The patient is administered heparin to prevent clotting, and protamine sulfate is given after to reverse effects of heparin. During the procedure, hypothermia is maintained; body temperature is usually kept at 28ºC to 32ºC (82.4-89.6ºF). The blood is cooled during CPB and returned to the body. The cooled blood slows the body's basal metabolic rate, decreasing its demand for oxygen. Cooled blood usually has a higher viscosity, but the crystalloid solution used to prime the bypass tubing dilutes the blood.**_

_**Now, we come to the mentioned 'Ross procedure'. **_

_**The Ross procedure is usually performed on patients younger than ages 40 to 50 who want to avoid taking long-term anticoagulant medications after surgery. During this procedure, the patient's own pulmonary valve is removed and used to replace the diseased aortic valve. The pulmonary valve is then replaced with a pulmonary homograft. It´s also called Switch procedure. Longevity of the pulmonary autograft in the aortic position is superior to bioprostheses such as porcine valves, which tend to degenerate after only a few years in patients under 35 years of age. Furthermore, anticoagulation is not required as with mechanical valves. Thus, individuals can lead an active life without the risks associated with anticoagulation therapy. This is especially important for women of child bearing age needing aortic valve replacement, as anticoagulation is contraindicated in pregnancy.**_

_** A homograft is a procedure where the patient's organ is replaced using a donor's organ. In terms of aortic homograft, the patient's aorta is replaced with a donor's aorta. An aortic homograft can be taken from two sources: human cadaver, and human heart transplant recipient whose replaced heart had a healthy aortic valve. The Ross Procedure is one type of aortic homograft procedure where the patient's aortic valve is replaced with his own pulmonary valve. A pulmonary homograft valve (valve taken from a donor) then replaces the patient's pulmonary valve. ** _

_** A autograft is a surgical transplantation of any tissue from one part of the body to another location on the same individual.**_


	20. Chapter 20

**Chapter 20**

* * *

**People have scars. In all sorts of unexpected places. Like secret road maps of their personal histories. Diagrams of all their old wounds. Most of our wounds heal, leaving nothing behind but a scar. But some of them don't. Some wounds we carry with us everywhere and though the cut's long gone, the pain still lingers. What's worse, new wounds which are so horribly painful or old wounds that should've healed years ago and never did? Maybe our old wounds teach us something. They remind us where we've been and what we've overcome. They teach us lessons about what to avoid in the future. That's what we like to think. But that's not the way it is, is it? Some things we just have to learn over and over and over again.** Scars and Souvenirs; Meredith Grey

* * *

_Post- op day one: _Meredith was sleeping soundly. Derek yawned and rubbed his eyes, he had been sitting here since she woke up. She had been up a few times over the last nine or ten hours, but only for a few seconds. Like right now. Meredith breathed subconsciously deep in and slowly, her eyes fluttered open a bit. It took her some seconds to adapt to the light. For a moment, she did not know where she was, then she remembered what had happened. Meredith remembered that she had open heart surgery a few hours ago. Her chest had been sliced open and her sternum has been broken. They probably restarted her heart with using the internal paddles. During the procedure her heart had been ice cold. Dead. Except for the fact that it hadn't been dead. It was just cooled down so it would not need that much oxygen while they were *repairing* her heart. She blinked and her eyes fell on the cardiac monitor that was beeping regularly every time her heart beats. Derek was half- leaning in the visitors chair and seemed to be dozen off.

Meredith had a small smile on her face when she saw Derek. His hair was messy, he looked tired. _He had been here all night. I told him to take care of himself. He ... _But before she could spent another thought about Derek she suddenly felt that it was harder for her to breathe. She could hear herself wheezing, soon her pulse oxymeter would start whining due to decreased oxygen levels in her bloodstream. Also, her chest hurt. _Ouch, it really hurts. This damned incision. Why did they have to do a total sternotomy?_ But somehow her medical skilled brain told her it was not just the incision. Maybe something much more serious, maybe there was a much more deeper cause for this.

She tried to ignore her troubled breathing reached for the PCA pump, maybe that would give her a little pain relief. But her chest protested immediately against the *sudden* movement even if she was barely moving.

She winced as pain shot through her.

Many little black points were blocking her vision, the whole room started spinning. Meredith breathed in deeply and tried to focus on the sleeping figure of Derek in the visitors chair. Contemporaneous, her pulse oxymeter started whining. Pulse ox was falling from 98% to very low 79%.

It was a significant drop and the alarm going off caused Derek to jolt awake.

Immediately he remembered where he was and why he was here.

Meredith.

Derek was like frozen, the only thing he could do was looking at Meredith and then back at the heart monitor. His breath hitched and a lump formed in his throat as he stared at the dropping numbers on the screen.

Alex, Izzie and the others were waiting impatiently of news on Meredith's condition but Dr. Bailey decided after Consulting with Dr. Webber and Dr. Burke that they should wait with telling them that Meredith is out of surgery and now transferred from post-anesthesia care unit, often abbreviated PACU back to Cardiac Intensive Care Unit where she is constantly monitored.

"Is her post-operative blood work back yet?" She asked a nurse in heavily manned nurse station. From there, you could see the rooms with nothing covered in the front of each room but a transparent plastic plating, so they could monitor all patients in cardiac ward who required frequent monitoring.

Meredith Grey was one of them, a few hours out of surgery and heart patient since birth.

"No, I am sorry. It´s not back yet." The nurse replied, checking something on the computer.

Bailey glared at her, then turned around to enter Meredith's room in CICU. She noticed the alarm coming from the pulse oxymeter and then her gaze went back to the vulnerable figure lying there with an exposed chest, wires and electrodes were covering it. Only the incision line was covered. Her lower body was covered with thermal blankets to help regulate her body temperature.

She has intravenous lines in the veins of her arms and her neck that will give her fluid and medications. And there was an PCA pump i. v. PCA with morphine: 0.015 mg / kg morphine bolus and 10-15 min blocking time without basal rate (if applicable morphine "loading dose" at Sternum closure device with 0.15 mg / kg). PCA is short for Patient-Controlled Analgesia. And the pulse oxymeter has gone off, it was beeping loudly. "Damn it, Grey, what are doing?" She exclaimed, then grabbed an oxygen mask and strapped it over her face so that it covered nose and mouth.

Then she looked at the monitor. Miranda Bailey needed to check if the oxygenation improves.

And they did, the values went up and stabilized.

"We´re good." She said, still her eyes were cautiously fixated on the monitor to detect potiential drops of Saturation but it seems like the breathing mask was doing its job and she was glad it did work but ...

"I am still waiting on the post- operative blood work. Lab's pretty slow today, but I say we schedule a post - op chest film to be sure that there are no pulmonary causes for this drop in her oxygenation." The general surgeon said with a frown. "I am sure it is nothing but it can't hurt to check, just to be on the safe side." She grabbed a pen and scribbled something unreadable in Meredith Grey's patient file. Just then, Meredith's lab report returned.

With a stern, almost somber expression she read through the delivered data.

Oh, no. This wasn't looking good, alarm bells were ringing, "Infection, attention, it may be an post - op infection."

Derek glanced at Bailey, who stared at the labs. Looking worried at the numbers that might indicate infection. "What's going on? Is something wrong with her? What the hell is going on? Why did her pulse ox drop? Why are you looking like that? It's ..." His voice quivered faintly. "Love you." She murmured, her voice was barely audible. "I love you too, Meredith. That is why you need to heal. We need you." Derek reached for Meredith's cold fingers and whispered encouraging and soothing words to Meredith, who received some mysterious signal to sleep and apparently hadn't been able redial.

Words she didn't hear.

"Derek." Dr. Bailey spoke to him, when Derek didn't react, she repeated his name louder than anticipated.

"Derek Shepherd, look at me." She said loud but gently. Slowly, his gaze focused on Dr. Miranda Bailey who still held the lab reports in her Hands. This was not good. This was a warning sign. He knew something was off ...

* * *

Alex is on Dr. Arizona Robbins Service. She was happy to have him on her service again and she showed him that. "Hey, Karev. You're joining us today?" She asked perkily and with a real, happy smile. Alex assumed she was having a great day, although Arizona had been always perky since he'd known her. Alex Karev answered with a half - smile and nodded. "I am on pediatrics again. Any cool surgeries I can scrub in on or any other work that needs to be done? I am free for everything and I would love to keep my mind of some things that I need to stop thinking about - just for a few hours." He explained and looked into Arizona's face. He was acting weird today but Arizona assumed it was because of Meredith Grey.

She had spoken to Bailey in the cafeteria and she had looked over Grey's file while she ate. "Yeah, actually I might need help on a kid with suspected nephroblastoma." She then told him.

"I am in." Alex said the second he heard about it.

This wasn't about scooping potiential surgeries. This was about keeping his mind off of Meredith lying in Cardiac Intensive Care Unit recovering from a major heart procedure. As far as he knew there weren't any complications but still - surgery is surgery.

"Great. I am looking forward to working with you."

"Nephroblastoma as in Wilms' tumor, right?" He asked, sounding interested.

"Right. What else can you tell me about it?" Arizona asked. She handed him a heavy patient chart. "Well, nephroblastoma or Wilms' tumor is a malignant tumor of the kidney, which has an excellent prognosis with adequate therapy. The median age at diagnosis of Wilms tumor is approximately 3.5 years. With current multimodality therapy, approximately 80-90% of children with a diagnosis of Wilms' tumor survive."

"Symptoms?" Arizona tested him. Alex answered after spending some thoughts about symptoms of nephroblastoma: "Typical symptoms are an abnormally large Abdomen. The first sign is normally a painless abdominal tumor that can be easily felt by the doctor, other non-characteristical symptoms can be abdominal pain, fever, nausea and vomiting, blood in the urine on about 20% of cases, high blood pressure in some cases - especially if synchronous or metachronous bilateral renal involvement." "Good, Let's see the patient." Arizona motioned him to follow her.

Before they entered the room, she gave a brief patient history: "Jake Klein, seven years, has gone through neoadjuvant pre - operative chemotherapy to shrink the tumor mass. He responded well to it and and we hope that with radical resection and subsequent post -operative chemotherapy he'll go into remission.

Alex nodded and then they entered the patient room.

Later, when their patient was being prepped for surgery to remove the tumor, Arizona noticed changes in Alex's behavior.

She wondered why, then she knew it. One possible reason for his behavior was Meredith Grey's surgery. At least that is what she assumed. She remember her talk to Bailey in the cafeteria.

But she wanted to know for sure. As they were washing themselves sterile, Arizona decided to talk with Karev. "Karev." She said, a stern and concerned look was now covering her face. "Are you in the game - fully?" She asked. "Yes, I am. "Why shouldn't I?" He asked back, slightly irritated. "Karev." Arizona turned to look at his face.

"Look, you're worried about your friend, I get it but this is ..." She paused for a moment. "... a fairly complex procedure. I need you to be fully alert and attentive. We are operating on tiny humans. They still have their whole life before them."

"Yes, I know that." Alex gave back. "And yes, I am worried about Mer. She is one of the people who gets me. I mean, I know most kids with CHD survive nowadays but hers was a palliative surgery. Her right ventricle is pumping ..."

"See, that's what I am talking about." Arizona cut his sentence.

"Your mind is occupied with other things - and that might causes problems." She said. "I mean, Alex, look. You're showing a great potiential in pediatrics. I have been working with you for months. You have a good way with children. But you're distracted by the fact that your friend's lying in ICU and I might have talked to Bailey and she said that she was worried about infection, so you've got every right to be concerned. But before I let you into that OR, promise me that you won't get distracted by anything." Arizona told him sternly.

Alex Karev glanced at the blonde pediatric surgeon standing there, her arms on her her hips and waiting for him to say something. He shifted uncomfortably. "You have to scrub again." He said. "I know." Arizona replied, "But are you sure you're okay with being in the OR?"

After a quick glance at the anaesthetized patient he nodded.

"I want to give him his life back." Alex said. "Good." Was all Arizona said. "Then let's get this show on the road."

* * *

"Her haemoglobin is a little low." Dr. Bailey began, she threw a repeated view on the lab report to overlook all the facts. Derek didn´t repond. "We will have to watch it. I hope it'll resolve on its own but if not she will need a blood transfusion." Bailey told the shocked neurosurgeon. "So let me get this straight," Derek emphatically questioned. "She needs blood? If her Hb doesn't improve then she will need a blood transfusion."

Dr. Bailey answered his question with a simple nod.

The neurosurgeon inhaled sharply, followed by a audible exhale. "I know it's a lot to digest but these weeks won't be easy. Maybe there will other complications - tension pneumothorax, atelectasis and post- operative pneumonia, maybe not which I hope will be the case. Anyway, we need to wake her up."

"Why do you have to wake her? She just went back to sleep. It's better if she sleeps." Derek said concerned.

Bailey nodded emphatically. "It is but right now ..."

"She needs to start clearing her lungs to prevent or to reduce the chances of catching post - operative pneumonia. You know it is neccessary and that I wouldn't to it if it were not neccessary."

"I know. It's just ... I hate seeing her in pain. I just want to live my life with her in it without long hospital stays due to cardiac problems. I didn't imagine how difficult it would be, to be ..." Derek didn't know what to say, he was at loss for words. "It is much more difficult when it's someone you love." Bailey nodded in understanding.

"Wait here. I will be right back." She suddenly said.

After awhile she returned carrying a special heart - shaped pillow they gave to recent bypass patients to clear their lungs.

She frowned apologetically.

"Can't it wait?" Derek asked for another time, he held onto her Hand, his gaze wandered to her face then back to Bailey.

"Please, not yet." Dr. Bailey shook her head. "She needs to clear her lungs. The last thing this poor girl needs is post- op pneumonia. So, yes, she has to do it now. It's best for her. Will you wake her? Gently?" Normally, this was a job that nurses do but since this patient is her intern she was the one who did it.

Derek pressed his lips together and nodded, even though he didn't like the idea of waking Meredith from sleeping one bit. Especially because of this, he really hated seeing her in that much pain. "Meredith." He gently said her name and laid his Hand on her shoulder. Meredith's eyes opened halfway, she was obviously confused and disoriented. Why is he waking her, her blue eyes said. Derek tossed her a silent apology.

"I am sorry." He mumbled.

Dr. Bailey checked her vitals and her pupils response she talked at her about How her surgery went and that she's stable - at least, for the most part. Dr. Bailey decided to take over and stepped forwards and handed her the pillow. Meredith wondered what and why they were all here? "Hold onto this pillow tightly and cough. It is going to clear your lungs." She told her intern who looked at her, her eyes were somewhat glassy. With shaky, weak fingers, she took it and looked at Bailey with big, blue eyes. She knew what that pillow was for and she wanted to protest.

She wasn't ready for that kind of pain. Derek bit his lip, carefully looking at Meredith's fragile figure. She hesitated for one or two seconds. "Come on, Grey. You can do it. When you're ready." Dr. Bailey *cheered* her on.

But Meredith did it.

She coughed.

A weak, muffled cough was escaping her lips and the results were immediate and torturous for Derek to watch. He watched Meredith cry out in agony, but because of the oxygen mask covering her face it sounded muffled. Tears were rolling down her cheeks and she squeezed her eyes shut because of the pain. It was just too much for her, the whole room was fuzzy. Spinning around her. She wanted it stop. Now.

The pain and the room spinning around her. She breathed hard and heavily, which was only resulting in more pain. It was a cycle that went on and on. So she put more strain on her recently broken sternum with each breath she took.

"You did great, Grey. You will be up and walking before you know." It was a lie and everyone in the room knew it was a lie. But it was one of those lies you ignore because they make you feel better. Meredith's breathing slowly went back to semi normal, but her chest still hurts like hell. She grimaced and winced.

Derek murmered soothing words, tried desperately to make her feel better.

After Dr. Miranda Bailey left the room, Meredith grabbed the PCA pump, clicked the button for more pain meds. She stopped after the fifth or maybe sixth click, maybe it was enough pain relief or she she gave up on ever receiving enough for the pain to stop. Derek felt his own heart beating hollowly in his chest.

* * *

Izzie, George and Alex were waiting for Dr. Burke and Dr. Bailey. They still haven't talked to them about Meredith's surgery, even though they knew from the nurses that Meredith was out of surgery and back in her room in Cardiac Intensive Care Unit. When Dr. Bailey walked past them, she was stopped by Alex's voice.

"What is going on with Mer. Is she out of surgery. We ... I deserve to know whether she is out of surgery or not. I was the one who saved her when she ..." He did not finish the sentence. He didn't has to, both surgeons knew what he was talking about.

"We heard she is back in CICU. Is that right?" George joined the conversation. For a Moment Dr. Bailey just watched the three of them. Izzie shifted uncomfortably. She felt like she didn't have the right to know about Meredith's condition.

Dr. Bailey sighed.

"Yes, she is out of surgery and back in Cardiac Intensive Care Unit. She is stable. But we will have to see." She said. "Can we see her?" Izzie stepped forwards, facing Dr. Bailey. She had avoided her for the most time after the *incident* with Meredith almost dying and she was responsible for it.

"No, you cannot see her! This poor girl's barely out of surgery and she doesn't need you fussing around her. She needs to focus on healing and she can't do it with you hovering. She is a patient here, a patient who just had extensive open heart surgery, and she deserves a little peace and quiet. So, no you cannot see her. Also, visiting hours are over. You can come tomorrow if she feels like she is up for visitors. I am sorry, guys but I can't allow you to visit her. At least, not yet." She tells them and by the look on her face her interns see that she really means what she says.

"But why is Shepherd allowed to sit by her side and hover? And Cristina? Why can they? I mean ..." "You mean it is not fair? I don't doubt that. But here is the difference. He is an attending, the head of neurosurgery and Cristina, well she is on her case. She is one of her doctors. That is why she is allowed to be in that room and unless-"

She gazed at the three of them, pointing with her finger at them, " ... you are on her case you are not allowed in that room. Do I have made myself clear?" Bailey asked sharply, gazing at everyone.

"Yes." They said in sync. "Good."

"Do you need anything else, like new assignments?" She said, asking. "Nope. I have a kid with a nephroblastoma, Arizona's letting me scrub in on it." In this moment his pager bleeped loudly. "Which is happening now." He said and disappeared to the ORs. "Good, Stevens?" "I'm good. I am covering the clinic." She quickly said. "I am good too." George answered. "Fine. Remember what I said. No visits, except in visiting hours. Are we clear?"

"Yes, Dr. Bailey." the two of them answered in unison. "Good. I will see ya guys tomorrow."

* * *

_Post- op day two: _Derek woke up. From noises and heavy breathing coming from Meredith. He wearily rubbed his eyes and looked at Meredith. She was breathing heavily. "Der ... I ..." She tried saying. These sentences cost her incredible strength. "Mer? Are you okay? What is going on with you?" He asked, panic evident in his voice. He touches her hand, it was sweaty, and her hands were also clammy. Meredith did not look very good. Her color was bad, she was pale and her lips were somewhat cyanotic. She looked sick and not like the Meredith he knew.

He was looking wretched. Spending that much time as a patient or as a family member in hospital will do that to you. Endless worry about Meredith could be seen in his gorgeous McDreamy - eyes. "Meredith." He said her name again. She shivered, like she had the chills. Now he was more than worried. 'Cause after surgery this wasn't normal.

Meredith shivered slightly and a soft moan escaped her lips, her eyes were half closed. Derek touched her arm, flinched when he felt the unnormal warmth coming from her. She felt kind of warm, as if she was developing a fever.

"Meredith." He spoke loudly, but from her came no reaction.

Meredith's pulse ox was falling too, even with the extra oxygen from the breathing mask. Maybe they need to try CPAP, to avoid reintubation. "Damn it." He mumbled when he checked her temp for the second time. It was definitely too high to tolerate and he wouldn't want risk it with her anyways. A fever could mean late - onset Hospital - acquired pneumonia, maybe even caused by multiresistant_ S. aureus_. He didn't even want to imagine that possibility.

Derek cared too much about her to let something happen to her, if he could have prevented it from becoming that bad. Meredith moaned again, then coughed up purulent sputum, followed by immediate protest coming from her chest.

Despite the amount of pain she was in, she tried to tell Derek that she is fine and that he shouldn't worry about her.

But that was a bunch of crap.

She was everything but not fine. She wasn't fine.

"Shh. Mer, don't talk. It's not good right now for your throat and all." Meredith tried to reach for the PCA pump, indicating that she was in pain. "It's all okay. You are okay." He said, stroking her hair. He was concerned about her. There were thousands of possible reasons why she could be showing these symptoms. That is when she starts having problems with controlling her breathing. Dyspnea. Meredith's breaths came out shallow and short, trying to get more air into her lungs but failed.

Derek decided it was time to do something.

This was not getting them anywhere.

"I page Bailey and Burke." He said, already reaching for his pager. When he didn't found it right away, he started searching for it frantically. Damn it. Where is my damned pager? Eventually, he found it.

After a while, it seemed like an eternity, Dr. Burke and Dr. Bailey stormed into the room. Immediately they started assessing the underlying Situation. Dr. Burke listened to her chest, checking for equal breath sounds on both sides. "She is definitely feverish. We need to check her temp. If it it's elevated this might be indicating an infection." Burke sounded worried. Soon they knew that her temp was lying above 102.2 °F.A beginning infection.

But what was the source of it ... What pathogen is causing it ... What was this for an infection ... Does she need to be isolated ... If it's HA - MRSA, she needs to be isolated.

"Didn't you order a chest film? Why wasn't it done?" He asked, eyeing Bailey.

"I ordered it." She answered with honesty.

"She did." Derek spoke up.

Meredith moaned slightly, her eyes were closed. Her cheeks were flushed and she was burning up. "We need to take up now for further studies. We don't have anymore time. Sorry Derek, but we need to move. Move." Bailey shouted and released the brakes of Meredith's hospital bed. Derek felt totally helpless when he watched Meredith being wheeled away. Chances are she has nosocomial pneumonia aka hospital- acquired pneumonia or post - operative pneumonia. This kind of pneumonia has a very high morbidity and mortality rate.

S_he can't die. She can't have HAP. It just isn't possible._

Derek just stared at the wall, desperate and worried so that he didn´t notice Cristina entered the room. "I wanted to visit Meredith? Where is she?" She exclaimed loudly.

"_**Derek**_." Cristina tried to get him to speak.

Derek was still frozen.

"Where is Meredith? Have they taken her up for some tests? What is going on, damnit Derek. Answer." Cristina was on the verge of freaking out. "Answer me! I am freaking out, really. Help me out here, Derek." She sounded shrill, almost hysteric. Derek looked up, tears welling up in his eyes and Cristina softened. They were both worried about her. "Calm down and then tell me what is going on with Meredith." After he took a deep breath in, he calmed down and finally able to respond to Cristina.

"They suspected she is coming down with post- operative pneumonia." He told her with a shaky voice.

"What? Oh, good. No, this cannot be true." Cristina looked at him in Horror.

Why does it always have to be Meredith who suffers all these complications. It just wasn't fair. Except, life is never fair.

"Where is she?" Cristina asked suddenly.

"Why?" Derek asked back.

"Did they took her up for some tests to confirm the suspected diagnosis? The wide list of differential diagnoses presents a major challenge in diagnosing nosocomial pneumonia. Many conditions other than nosocomial pneumonia mimic pulmonary infiltrates on chest radiographs. So they need to confirm it with many many tests." Cristina held herself up by saying medical facts out loud.

"They did. I think they wanted to do a chest film. They did wanted to do one yesterday but somehow they just didn't do it. I don´t why I did not pressed them into actually doing it. They could have started her on the right antibiotics back then. Now I feel like it's my fault. I just don't understand ... Wait, Cristina where are going?" He called out when Cristina left the room.

Yang stopped and turned around.

"You said they wanted to do a chest film. I want to see what they are doing with my person." She told him.

"I am coming with you." Derek followed her to _Diagnostic Imaging_. "What are you two doing here." Dr. Burke said when he saw Cristina and Derek storm in the CT room while they were waiting for the results. "Did you run her labs?" Cristina asked, panting. "Not yet." Dr. Bailey answered shortly, looking demonstrative in another direction. "Cristina." Dr. Burke said loudly, trying to get her attention. "What is going here? Why haven´t I been paged? I am on her case, also she´s my person."

"That is exactly why you haven't been paged. You are too close to do anything good for her right now. I am sorry, Cristina but you are in no condition to be a help for her."

"Screw it." Cristina said, almost inaudibly and entered the room where the CT machine was.

She wanted to be with Mer, to show her she wasn´t alone. Derek followed her.

"Yang, Shepherd. Get out of there. Now. I know you are concerned about her but you aren't allowed to be here." Dr. Burke told them over intercom. He sounded stern and not as arrogant as always. Not when it is Meredith. She has to get through this. They just repaired their heart, she can't just die.

"Whatever, we are both doctors here, so just screw it. It doesn't matter. Also, it is not like we are getting in the way like other families would." Cristina gave back. She was ready to fight to be here. Her person needed her, she needed them pulling for her even though she is only semi - conscious and on the way to lose consciousness at all.

In line crackled, there was a rustle and a muffled sound, Dr. Preston Burke's voice was cut off sometime and they didn´t understand everything he said. But he allowed them to be there for Meredith while they were doing the study.

Dr. Preston Burke and Dr. Miranda Bailey were meanwhile waiting for the scans to come up on the screen. "What is taking so öong." Bailey complained about the slowliness of the machine. The machine seemed to screw them. It knew that is wasn't any patient and it screws with them. This seemed to take forever. Impatiently, she stared at the monitor and when they came up she was the first one to see them.

"They are up." She exclaimed, studying the image appearing on the computer screen.

Dr. Burke followed her gaze and studied the image too. He was not very pleased with what he saw.

Not even a little bit.

"Can you see this?" He asked. Only it was rhetorically. Dr. Bailey did see it, actually. "Oh. No." She quietly exclaimed, worry filled her brown eyes. "You see it too." Dr. Burke stated and clicked on the image so that he can see it in large. The Computed Tomography showed pulmonary infiltrates, but it weren't conditions like atelectasis or anything like that.

It was pneumonia.

Grey had catched post - op pneumonia. They needed to check the i. v. access and the catheter for the urine and all the other lines she had still. They might be the source of infection. If it was MRSA they needed to inform the 'Center for Disease Control and Prevention'. If it is, they needed to inform the CDC about the infection. "Hopefully it's not methicillinresistant _S. aureus_." Bailey said put loud what everyone feared.

"Let's just hope that."

The shades on the roentgenogram confirmed that existed a lobar pneumonia caused by some kind of bacteria. They have not quite identified the strain yet.

The scans only confirmed their presumed diagnosis - nosocomial pneumonia.

"We need to figure out what strain is causing this and we need to start her on antibiotics right away." Burke ordered. "We'll take samples and they should put a rush in it in the lab." Burke said, still staring at the plain radiograph of Meredith Grey's chest.

"Damn it. Why can't this girl catch a break from things like that?" Bailey asked loudly, but she asked no one specific.

After that they also did an pulmonary ventilation and Perfusion V/Q lung scan. "We are doing the V/Q scan together. It is usually always done that way and an additional chest x-ray." Dr. Burke said, while preparing for the procedure. "Okay." They also ruled out heart failure by an electrocardiogram, cardiac enzymes, and Swan - Ganz readings.

After they finally did run labs, they have discovered that Meredith's _white blood cell count_ was elevated, but that doesn't say anything concrete. Other conditions that mimic that kind of pneumonia can have the same lab results. They decided to start her on antibiotics now even if they hadn't identified the strain yet.

But then, Meredith's heart monitor shrieked.

Simultaneously, Meredith who was semi conscious, cried out in pain. "Meredith. Can you hear me? We are going to take great care of you." Bailey assured her. An acute febrile episode, purulent sputum production, and pleuritic chest pain may occur in patients with an pleural effusion associated with pneumonia. She coughed up purulent sputum. Dr. Bailey ordered tests to rule out pleural effusion. And well, she did have an pleural effusion. "How could this happen? She has a chest tube, there shouldn't be anything to drain. Maybe it is kinked or clogged? But that could be fatal ..." She murmured.

Bailey decided to remove it, despite the fact that might need it but when it is clogged it would do more damage than good. So she removed the old tube and replaced it with a larger diameter chest tube. But still, Mer's pulse ox was still falling ...

_Peep. Peep. Peep._

It made a alarming sound signaling that oxygen saturation was dropping uncontrollably.

They needed to put her on a mechanical ventilator. The oxygen mask wasn't working.

She took yet another dive downwards, rapidly declining. "What is going on ..." "Outside. Now." Bailey shouted as the monitor went crazy. Heart rate also bottomed out due to the lack of oxygen, she was becoming hypoxic. "No, we stay. She needs us." Derek protested, he was not taking his eyes off of Meredith.

"Get out, now. I am just saying it once." A nurse pushed them outside and closed the glas behind them. Derek and Cristina were shocked how rapid her condition deteriorates. But since it is late - onset Hospital- acquired pneumonia ...

"We should intubate." Dr. Burke said, watching Meredith's sats dropping.

"Continous Positive Airway Pressure isn't working. She is going into respiratory failure due to post - operative pneumonia. Damn it, we need to get her on a mechanical ventilator. Bag her while I get an intubation tray ready." He advised a nurse, who nodded and grabbed the disposable BVM Resuscitator and started bagging her so that Meredith gets enough oxygen while she cannot do it on her own. While a ICU nurse started with Manual Ventilation, Dr. Burke shouted for an intubation tray. Here you go, Dr. Burke." A nurse said as she handed him the endotracheal tube.

He grabbed it and asked with a sharp voice for a laryngoscope, signaling that they have no time to lose: "Laryngoscope, now. We need to maintain her airway. Now. Hurry."

Immediately, the nurse followed with a laryngoscope.

"Step aside. I am going to intubate now."

The tube is passed through the mouth and vocal apparatus into the trachea, then a balloon cuff is typically inflated just above the far end of the tube to help secure it in place, to prevent leakage of respiratory gases, and to protect the tracheobronchial tree from receiving undesirable material such as stomach acid. Dr. Burke then secured the ET to the face or neck and connected to a mechanical ventilator. When finished, Dr. Burke pulled out his stethoscope to listen for equal breath sounds.

"Breath sounds are equal. Turn the vent up to 95%." He said in a professional tone.

"We will reassess the whole situation in a few hours."

When he left the room, he saw Cristina and Derek standing there. Their faces showed sheer horror and panic. But also worry.

"I can't believe this is happening-" Cristina trailed off, her voice flat. Toneless. Almost empty, Burke guessed she tried not to be attached. Except she was. "She can't die. She is my person, I need her._ We _need her to be alive."

"How is she doing?" Derek asked.

"Don't tell she is okay. She is ..." His voice broke. "She is back on the vent."

"We started her on antibiotics but we don't know. The vent is doing 95% of the work. The settings are pretty high, she isn't doing much of the work herself. Her body is very weak. She may not make it." Tears clouded Derek's vision as he continued to call her name. He broke down sobbing. All the stress from the other days was now coming up and taking its tribute.

"Come. Sit down, Derek." He heard someone saying, he assumed it was Mark Sloan. Through his tears he recognized Addison standing next to him, Alex and the other interns were being there for Cristina, who looked wretched.

"So, Yang." Dr. Bailey's voice cut the silence, the interns were to shocked to fully comprehend what had just happened before their eyes. "All of you, go home. There is nothing you can do for now." Bailey told them to.

Neither of them listened to her which was to be expected.

"I stay." Izzie said, "Me too." Alex shrugged as if it didn't matter to him. But it did. He just didn't show it.

"Whatever, I don't go home today, I need to check on my nephroblastoma kid. Arizona said I should Monitor him over night. So, it is kinda clear that I am staying." "No, you are not." Nobody had seen Arizona coming. But the blonde pediatric surgeon stepped up and made Karev look at her: "You are not staying over night." She told him in a professional matter.

"See, you are worried about your friend. You did a really good Job today in surgery. I am going to Monitor Jake. It's okay, Alex." She told him.

"I guess I should thank you, Robbins." He said, looking through the glass to Meredith's small frame lying there. A vent breathing for her. But he told himself that Meredith wouldn't cop out now, she was resilient. She just has to be.

* * *

_Post- op day three: _Dr. Bailey was there, checking Meredith's vitals repeatedly. Derek was sitting on a chair next to her bed. Just like he did the last three days. But now, she could still ... die. It was a complete nightmare and it had just started. They've started her on some strong antibiotics. nurse entered the room with a bag containing one unit of blood. "I have the blood." She said. "Good. We will start blood transfusion soon." Bailey answered.

"But how will it affect her, with the nosocomial infection and all?" Derek asked worriedly.

"I don't know. We'll see." Dr. Bailey answered. Derek just shook his head. This couldn't be true. Bailey always had been the one with the answers. "What you don't know? You're her doctor you are supposed to know this." Derek snapped at her. Bailey breathed in deeply. This situation was more than serious.

"Do you think she will survive this infection?" He asked. "I wish I knew. I wish I had an answer for you but unfortunately, I don´t. And believe me when I say it sucks. It sort of does suck to just wait and see what is happening. But that is what we need to do. There is other ... Let's just hope that the antibiotics start kicking in soon." Bailey hoped her intern would be strong enough to pull through this.

Derek buried his head in his hands.

It was just all to much. "I am sick of hoping and wishing everything will be okay. I am sick of half fixes. I am ... God, I need to ..." Suddenly he just disappeared, couldn't take it anymore. "I am sick of waiting." Bailey heard him saying.

Dr. Bailey let him go, she just hope he wouldn't do anything stupid.

"Grey. I don't know if you can hear me ..." She whispered into her ear.

"But you better pull through."

_Peep. Peep. Peep. Peep._

"That is not what I meant, Grey." Bailey exclaimed as her heartbeat got somewhat irregular.

"Don't do this now."

When she had Meredith stabilized she inhaled and then slowly exhaled. Derek wandered through the hospital. He came here for a Job opportunity and now it was so much more. It was his life. Meredith was his life, he couldn't exist anymore without her. They all looked at him with pity, as if he would break at any moment.

* * *

"Shep." He heard Mark's voice behind him. "How about we go to Joe's? It will help you clear your mind, to get your mind off of Meredith. It will do you good. You need this and deep down you know it. You can't help her anyway. It is up to Burke and Bailey and most important, it is up to Mer, whether she fights or not." Derek turned around, facing his best friend.

"Come on, man. You know I am right and don't even think about punching me for trying to help you out. 'Cause that wouldn't be very nice."

Derek smiled a small, fake smile.

He said: "What if she dies the minute I step out of this hospital and I don't ever get to say goodbye to her?"

"She won't do this. To you and to Yang. She loves you to much to just give up. We will be on the other side of this freaking road. They will have nurses page you if anything happens and Mer wouldn't want you to do this to yourself. So, just for an hour get over yourself and Let's go to Joe's bar."

Resignedly, Derek nodded.

Mark wouldn´t have accepted a no, so he kinda did not have choice.

"Ah, Derek. It is nice to see you. What do you want?" Joe asked, sounding happy to see the two surgeons entering the bar.

"Single Malt Scotch." He replied, his voice dark and ful of fear.

"Hey, what is wrong with your face?" Joe asked, bewildered by the grave- like look on Derek´s face.

"Nothing."

Derek was not really in the mood for chitchat. Not with Meredith barely hanging on.

"It's Meredith. She has nosocomial pneumonia and it isn't looking very good." Mark explained to the bar owner. Joe did not looked like he understand what that means. "Okay, I am assuming that this is some post - operative complication Which is life- threatening?" "How do you know she's had surgery." Mark asked.

"I own a bar. I know things and the gossip here is kinda hard to ignore. Also, Yang was here. Alone, without Meredith. She wanted straight Tequila but since she does this every time she is here, I figured nothing is wrong. But after a while, when she was, well, in a more drunken state she spilled some things - about Meredith needing open heart surgery. I guess it is true-" He motioned towards Derek who taking a sip of his Scotch.

"Otherwise he would not be sitting here with that kind of face."

"Wow. Gossip really spreads around." Mark laughed - Derek sent him a gaze that would have killed him instantly if glares were able to kill.

"Oh, shut up, Mark. You don't know what this feels like. It feels like someone rips your heart out of your chest and there is nothing, absolute nothing you can do about it. I can't save her because you know it is not a brain thing. I don't do cardio. I do brains, not hearts. I ... I don't know what to do anymore, Mark." Derek admitted that he was only human, it was a huge step for Derek to admit something like that. Mark did not know what to do.

For once, he did not know what to say.

* * *

_Post- operative day four:_ "Temp's gone up to 105,2. She isn't responding to the meds."

"What do we do?" Bailey asked.

Grey still was lying there, totally lifeless with that tube shoved into her mouth and the ventilator breathing for her. Silence was there, accompanied by the beeping of the monitors and the other devices that monitored her vital functions.

"I think I have read a something in an article about a study that said that bronchoscopic bacteriologic strategy was shown to reduce the short - term mortality risk in patients. Maybe we should try it with Grey, well it cannot hurt." Dr. Burke looked like he considered it. Derek wasn't here. He was resting in some on call room.

Bailey and Burke were standing there, discussing about what's best for Grey.

"Maybe we can try it. But first, we need to find the right antibiotics that really work. Multi drug resistance is common in late - onset pneumonia. So it is difficult to treat. I have to go, figure this out. She needs combination therapy using an antipseudomonal cephalosporin, beta lactam, or carbapenem plus an antipseudomonal fluoroquinolone or aminoglycoside plus an agent such as linezolid or vancomycin to cover MRSA. We are going to treat this as aggressively as possible." He said.

"What about bronchoscopy?" Bailey intervened.

"If the antibiotics don't start working, we might consider this but let's see if changing her antibiotics help matters." He said.

Derek suddenly was standing there. "You have to do more than just changing her antibiotics."

He breathed heavily.

"Who says changing her meds will have an influence?"

"Derek, I told you to go home." Bailey said, looking at the broken Frame of the neurosurgeon. It was hard to see her colleague and friend like that.

"I can't." He said. He looked terrible. He looked like he was going to pass out any second. Bailey slowly cornered him. Derek recoiled but had to stop when he felt the cold, hard wall behind his back. "Derek Christopher Shepherd." She adressed him. "Please tell me that you have gone home to sleep." He shook his head, drew out a deep breath. He didn't looked at Bailey. He was afraid of what she might says. Not that it would changed anything but, well, men and their stupidity.

"Have you at least eaten something?" Dr. Bailey inquired him.

Discouraged, Derek shook his head. Bailey would either way to find out, so what the heck.

"When was the last time you ate something, like real food. Because I've only seen you here, sitting by here bedside ... Derek, what are ya doin'? Meredith sure as hell wouldn't want you to do this to yourself. So get yourself something to eat or I'll give you an infusion.´Do you want me to do that?" She gave him her infamous speech.

Derek did listen, but did not remember any of what she had told him just minutes before.

"Listen to me, Shepherd. I will do it. I have no intention of you ending up in a hospital bed too and if it means sticking you with a needle to get fluids into your circulation system. I get that you are worried about her but you ending up in a hospital bed too isn´t going to do any of you good. So, please do me a favour: eat and drink something. There is a cafeteria downstairs."

"I will make sure that he eats." Mark's voice came from the door.

"Thanks Sloan. If he doesn't he'll get an infusion. So make sure that he eats. I don't want him to pass out over worries for his girlfriend." Bailey eyed the neurosurgeon for a moment.

"Come, Derek. Miranda's right, you need to eat." Mark tried to convince his friend.

Both men disappeared downstairs, they were heading for the cafeteria.

* * *

_**A/N: Hey, there again. Thanks for reading. This chapter was kinda difficult to write. I don´t know how a sternotomy scar hurts ... All this is simply based on a lot of research. Medicine is veery complex field. After this chapter, I am done torturing Meredith. For now. But my story isn´t anywhere near finished. It has just started. But I promise, things will get better for them, at least for a little while, they get some peace. The next chapter will focus on Meredith's recovery. **_

**_Medical notes: _****_Hospital-acquired pneumonia (HAP) or nosocomial pneumonia develops at least 48h after hospital admission. Nosocomial pneumonia is the second-most-common nosocomial infection and is most prevalent in medical and surgical intensive care units (ICUs). It is usually bacterial in origin. The most common pathogens are gram-negative bacilli and Staphylococcus aureus; antibiotic-resistant organisms are an important concern. Although most patients with nosocomial pneumonia develop fever and leukocytosis, these findings are not uniform and are not a requisite for the presumptive diagnosis of nosocomial pneumonia. Respiratory tract symptoms include an increase in respiratory rate, shortness of breath, and a productive cough. Diagnosis is suspected on the basis of clinical presentation and chest x-ray, CT and is confirmed by blood culture or bronchoscopic sampling of the lower respiratory tract. Treatment is with antibiotics. Overall prognosis is poor, due in part to comorbidities._**


	21. Chapter 21

**Chapter 21**

* * *

**After a trauma your body is at its most vulnerable. Response time is critical. So you're suddenly surrounded by people. Doctors, nurses, specialists, technicians. Surgery is a team sport. Everyone pushing for the finish line. Putting you back together again. But surgery is a trauma in and of itself. And once it's over, the real healing begins. We call it recovery. Recovery is not a team sport. It's a solitary distance run. It's long, it's exhausting and it's lonely as hell. The length of your recovery is determined by the extent of your injuries. And it's not always successful. No matter how hard we work at it, some wounds might never fully heal. You might have to adjust to a whole new way of living. Things may have changed too radically to ever go back to what they were. It might not even recognize yourself. It's like you haven't recovered anything at all. You're a whole new person with a whole new life. **It's A Long Way Back; Meredith Grey

* * *

_Post- operative day eight: _Meredith stirred a little bit. Derek could not believe what he saw. "Mer?" He asked with a quiet and shaky voice. Meredith'hs eyes slowly fluttered open. But she couldn´t talk. She was still intubated but the ventilator only assisted 55%. So that means the vent forces her, for every breath she took on her own, to take another breath. She was almost ready to come off of it. Meredith tried to form words but the endotracheal tube was not allowing it. It was obstructing her airway. She wanted that thing out. "Sshh, Meredith. It is just the tube. It´ll come out soon. But just let it do its job." Her eyes were full of questions, and she was telling him with an intense gaze that he should tell her what was going, why she was intubated. Reintubated_. _"Just relax. I'll page Burke and Bailey right now. Oh, and Cristina. They will be so relieved when they hear that you are awake and responsive. You had me really worried. I am still worried about you. But, it's all okay now."

Meredith closed her eyes for a second, then she opened them again and focused at Derek. He grasped her hand and squeezed it gently. He noticed that her hands were still cold. But she was alive, finally, the antibiotics had started working. She was going to be okay. He was so grateful for that. Before he knew what was happening tears were rolling down his cheeks. Tears of undescribeable joy he now felt. Like in Trance, he grabbed his pager and paged Dr. Bailey, Cristina and Dr. Burke. Hopefully they could take her off of the vent in a few hours or at least lower its assistance.

"You are okay now, Meredith. You will be okay. You are still on the vent ..." He whispered. Meredith did not look like she liked being on a vent, it was a quite uncomfortable feeling in her throat. Also, it keeps her from breathing on her own.

Meredith's blue, intense eyes were focusing him, gazing at him. He pressed her hand softly, he was elated when Meredith replied the pressure with a squeeze, then he placed at short, gentle kiss on her forehead. What happened, he could read lots of questions in her eyes. He hesitated. Only the constant beeping of the cardiac monitor could be heard, reminding him Meredith's heart was steadily beating. The pacemaker was doing its work. His fingers traced along her arm, finding the intravenous access in her wrist. "Does anything hurt?" He asked Mer, he was scared of her answering with yes, but she did not. Her head moved slightly, almost imperceptibly. No, she was not in pain. Thanks to the pain meds she wasn't feeling any pain. What a huge relief. He couldn't image how confusing that must be. Lying here with all these beeping, blinking, noisy devices and the whole not being able to talk thing because of the mechanical ventilator.

Derek breathed a sign of relief. The ventilator shoved a breath through her torso, showing him how fragile she still was. Derek had tears in his eyes. He watched Meredith's chest rise and fall each time she took a breath or the ventilator shoved it through the tube into her lungs that were still inflamed. Even if it had gotten better. Her sat had shown a greater improve, that was good. Very good.

_Why am I on a freaking vent?_

_What did happen when I wasn´t, well, conscious?_

_Derek Looks like hell on earth. Like he hasn´t slept in days ..._

_What is going on, I really need to find that out._

_I need to talk, write anything ..._

Meredith's eyes were half open and half closed.

He wasn't sure if she saw him, but for sure she was feeling his presence.

"Mer." He softly said her name. Meredith drew in a deep breath herself, through the tube connected to the mechanical ventilator without its assistance. She did took a breath without its help. Derek looked into her face. It was still pale but much better than when she was four days post- op and fighting against hospital- aquired pneumonia. So, breathing over the vent is a good sign. That was a good sign. It really was. Meredith was getting better even though it had been an uphill climb. But they will make it through this whole thing. He looked at her chest, it was invaded from drainage tubes that were supposed to drain out water and blood. The ECG leads connected to electrodes on various points on her chest ...

It was hard find a normal piece of her soft skin.

Then she took another breath on her own. "Good job, just keep breathing like you are." He supported her with quiet but strong words. Meredith blinked and started to look around the room. Everything seemed cold and sterile. Like in a hospital in an ICU room.

Derek noticed her uneasiness.

Derek started talking to her, he was trying to keep her calm. "Hey, Mere, I am here." When she heard Derek's voice, she relaxed and her heartbeat slowed a bit down, back from sinus tach to a normal sinus rhythm. Again she was breathing over it. Her eyes were asking questions, lots of them. But Derek did not want her to what had happened. At least not yet. She should focus on recovering and getting better. "I am here." He repeated softly. "Cristina will be here soon too." He then said, "Dr. Burke made her go home, she had spent the last few days in an on-call room somewhere on this floor ..." He trailed off.

_What is going on here. Why won´t he tell me?_

She was pretty sure that there was something he wasn´t telling her. Intentionally not telling her, presumably to protect her. That sounded like Derek. Meredith suddenly felt very tired, the whirring of all the machines sounded in her ears. She wanted to feel Derek's presence but the weariness took over, it was like her brain doesn´t have the power to hit redial even if she wanted to. So her eyelids slowly closed and she couldn't do anything about it. The next time she woke up, she heard Derek talking to another voice in the room. She couldn't understand everything they said, she just heard some bits and pieces that she couldn't make sense off.

But still, she tried to understant what Derek and this other person were talking about.

"... lower ... " Someone said. "She ... breath ... ov ... lower usage percentage ..."

They were talking about her, about lowering the vent. Meredith was doing more and more work on her own. So they really could lower its assist to see how Meredith responds to that. "Let's ... I am check.. h ... vital fuctions ... we ... anyth ..."

"You ... it's a good ..." Derek replied, his voice sounded hopeful.

The other person answered something but she just couldn't understand what. They were standing too much away from her bed, plus they were talking extremely quietly. Meredith's thoughts wandered to another topic. She listened to the beeping of the heart monitor, then back to the conversation from Derek and she guesse d, some other doctor who was treating her. Probably it was Bailey or Burke. At least that would make sense.

She tried to give them a sign that she wanted that tube out, it was starting to bug her.

She wanted it out. Ad acta.

"Meredith?" Derek asked when he saw her hand motions toward the tube. "She wants it out." He said to someone standing behind him. "Let me check her vitals."

Someone was coming over to her bed, checking the intravenous line that dripped meds and hydrating fluids into her system via a catheter shunt. "Grey!" Someone said her name very loudly. Meredith blinked in response. "Grey. Can you hear me?" "She can." Derek answered for her. Meredith sent a silent 'thanks' to him, but Miranda shushed him with a sharp and commanding voice: "You, be quiet." Meredith rolled her eyes, she was surprised she could do that in her current condition. "Well, it looks like you are right. She might be hearing us. If she didn't she wouldn't roll her eyes." Derek laughed. "That's my Meredith." He said. Bailey huffed and turned her attention back Meredith. "Meredith, can you blink? For me, it's Bailey. Your resident." Meredith followed her intructions and blinked. "Good." Bailey responded with a smile.

Now Meredith recognized the voice. It was her resident. Dr. Miranda Bailey checked now her blood pressure. The automatic blood pressure cuff constricted around her arm sighed as it released.

"It is nice to see you awake. You had us all worried. You know that, right?" She told her intern, she looked tired but happy. Meredith was pretty sure it had to do with her. Meredith looked questioningly at Bailey, at least so much as the ventilator allowed her to do. "You didn't tell her?" Bailey's gaze went to Derek who looked aside. Derek doesn't want to face Bailey. "Tell me that it is not true." "She has to heal, Miranda. I am not endangering her recovery with information that I could tell her after she is out of the woods.

I am still not out of the woods, Meredith wondered silently. I am feeling fine. I am fine. There is no need to worry. She wanted to tell Derek that he didn't need to worry about her, that she was fine. She would be okay. Will be okay. But she couldn't tell him that because of the tube that was still down her throat and it didn't look like it would come out anytime soon.

Her gaze wandered to the heart monitor and checked her rhythm. It was a normal sinus rhythm continued by the pacemaker stimulation. Now there wouldn't be an AV blocks or sinus node arrest. She breathed in and the tube went white from the vapor. When Burke entered the room, followed by Cristina. "Meredith." She exclaimed. "You're here. Awake. God." She practically flew to Meredith's hospital bed and threw a view over to all the monitors and to Derek, who was obviously more than relieved that Meredith was awake. Meredith tried to say something but the damn tube was in her way. It was blocking her airway. She did not need it anymore. She was perfectly capable of maintaining her airway alone - without the help of the mechanical vent. She motioned to the tube, softly gathering strength to try to pull it out. But Cristina softly stopped her from doing that.

"Don't pull it out. You will hurt yourself, Meredith." She said. Meredith motioned to the tube, again. Why didn't they get it? She wanted it out. This time, Bailey told her with a calming voice: "It'll come soon. We lowered the usage percentage of the vent and if everything goes well, you'll be off of it in the next hours." "See, a few hours aren't long." Cristina supported her person. "It will be out sooner than you know." That's easy to say for you, Meredith thought to herself, but then she heard Cristina saying something important.

"Thank you for not dying." She said, tears in her eyes.

Meredith blinkte and searched for Cristina's hand and pressed it reassuringly. I am okay, she wanted to tell her that and that they shouldn't worry. She was okay, really. Not fine, she was okay.

Derek asked a question: "How is she doing besides the fact that she is almost ready to come off of the ventilator?" Bailey looked at the neurosurgeon. He suddenly thought like a doctor and knew there were also other things that are important. "She is doing great." She answered, overlooking her most recent labs she'd run and the other tests they did came back okay. "Her lungs are working much better now. She really recovered fast from the pneumonia. That is very good. There still is a bit wheezing but it'll disappear when she completely recovers. But we'll keep an eye on that and maybe we do another set of chest films just to be sure her lungs ... that the antibiotics are working. To be sure we haven't missed something." Derek nodded. He agreed with that 'Be sure nothing had been missed'- approach.

"Sounds good. What about her ..." He glanced at Meredith who listened to Cristina who was telling some funny stories. Dr. Bailey looked at him expectantly. "... kidney function?" He finally finished his question. Dr. Bailey gazed at the neurosurgeon and then said: "It's hard to know what can happen, right?" Derek nodded and looked at her, searching for an answer. "They are functioning, her urine output was pretty good. So there is no need to worry." She reassured him. Derek answered with a quiet voice: "Thanks." "It's going to be okay. She's going to be okay."

Dr. Bailey left the room of the Cardiac Intensive Care Unit but before she left, she said: "Page me and Dr. Burke when her condition changes. Hopefully for the better than worse." Derek nodded. Cristina told Meredith about some work- related things that doesn't interest him. So he said, "I will go home since I know you are okay. I promised you that I would take care of myself. So I need to take a shower and eat. The food I had was only some disgusting sandwiches from the vending machine down the hall and coffee." He told her. Meredith's eyes widened when she heard that. In this moment, his stomach growled, it was audible despite the whir of the vent.

Meredith tried to signal him that he should eat something. That wasn't what she had in mind when she told Derek to take care of him. She tried to tell him with her eyes that it was okay to go home and eat, sleep and take a shower. Derek smiled his McDreamy smile, but right now this wasn't working. "It's okay." Cristina said who could read Meredith better than a book. "She wants you to do whatever you need to do. She wants you to take care of you." She told him. "I know she would want that." Meredith nodded slightly. She was breathing over the vent, the usage percentage dropped a little bit. It was now only 32%. In a few hours she would be off it. She would be fine without him for a couple of hours. Maybe, when he came back, she was ready for extubation ...

"Okay." Derek said. His gaze went over to Meredith, then to her heart monitor and checked it for any signs of arrhythmias. But the monitor showed a normal sinus rhythm which about he was glad, more than glad. "I will be back soon." Derek said. Meredith released a huge breath without the vent. Derek went over to her and kissed her on the forehead. "I love you. Don't forget that." He said. Meredith blinked and her cold fingers were searching for his hand. Derek quickly found her hand and pressed it gently. "I'll be back soon." Then he slowly released his grip on her fingers and glanced at Cristina. "You will be here the whole time, right?" He wanted to know.

Cristina nodded.

"Meredith and I will be just fine. Go. She will be fine. I'll make sure of that. I will be here the whole time." A small hint of a smile could be seen on her lips. Derek nodded, turned away from the room but then he went back and gave her another kiss on the forehead. Meredith looked into his face. Seeing his blue eyes looking at her and for a moment, just for a moment she forgot where she was. "I love you." He murmured, softly brushing his hand through her hair. For a moment her eyes closed. Cristina watched the scene. They really loved each other. Meredith's eyes remained close, she was sleeping. Healing. "I'll leave you two alone." Derek said, before he left the room and went to get his car and drove home, to Meredith's house.

* * *

Lexie Grey was on the way to Seattle because she wanted to visit her family. Her sister Molly was pregnant and she had besides the medical studies at Harvard Medical School found the time to visit her family. Molly was in the hospital, there were complications during pregnancy and her little sister was therefore at Seattle Grace Hospital being treated. Now the baby was born. However, there were also problems after the birth of her niece. Lexie didn't know any particulars about the current situation. Susan had not told her very much over the phone, but she did worry about Molly, which was understandable. But she was also happy to come home. To be with their parents and visit old friends. But most of them already moved away to go to university or they went to see foreign countries. But anyway, that's beside the point.

She loved the feeling about being back home. At least for a weekend. It was raining again and Lexie sighed, turned the windscreen wipers and focused on the road. It's cold and wet outside and there wasn't very much light. It was getting darker and darker.. Hardly, a car was driving on the road on this desolate interstate ...

The road was a bit slippery and Lexie's car made a swerve on the opposite lane. Luckily it did not hit another car or a tree that was in the way, luckily, there weren't any cars so that wouldn't be the chance to hit one - which she had been relieved about when she had her car back under control. Her family had been busy worrying about her younger sister and she, well, she was the one with the good grades and goes to med school. Anyway, they were already worried about Molly and her little daughter Laura Grey, so it would be better to get there in one piece. In addition, Molly's husband Eric Thompson was still stationed in Iraq and it would take its time until he would come back home. Lexie saw her family too rare since she had begun studying human medicine. She wanted to become a surgeon. It was her dream since she was a little kid.

To distract herself, Lexie turned on the radio. But there wasn't anything interesting. Just some news. Political and economic issues were being discussed. Something about Syria or Iraq, she didn't get it all. Then the weather report for Seattle was aired. Lexie turned up the radio and listened to what they say about the weather. But the reporter just said, that it would continue to rain for the next days. Great, she thought. But she wouldn't spend much of the time outside. She was going to spend it with Molly in the hospital. Her car began to slide and quickly, she responded that it stopped sliding around on the wet road of Interstate like that. Then she reached Seattle. She liked that city. It was where she grew up. It was near the ocean and it wasn't hot all the time. After thirty minutes she reached her destination: Seattle Grace Hospital. She was there.

She parked her car in the next spot she saw and entered the building. Rain was still falling. When she reached the reception desk, she asked a nurse for directions. Then she made her way to the floor Molly was lying on. She felt her heart race in her chest when she pressed the elevator button-

* * *

When Derek opened the door to Meredith's house, he noticed someone in the kitchen. Maybe it was George or Izzie, one of Meredith's roommates. Presumably Izzie who was baking muffins. That would explain the smell. "Hello. Someone here?" He called loudly. First, there was no answer. Then there was a loud rumble and a curse. "Damn it." Someone said and Derek slowly went into the kitchen. Then he recognized Izzie. "Hey." He said, as his gaze scanned the kitchen. The kitchen was a complete mess. There were muffins standing on the table. He was sure they were still warm.

"Can I take one?" He asked. Izzie turned around, she was very surprised to see the neurosurgeon here.

"Dr. Shepherd." She stuttered, taken by surprise. "Yes ... of ... of course you can." She said nervously.

Derek nodded. "Thanks." He said, he took one from the plate and started eating. His stomach immediately wanted more. He didn't know how hungry he was until now. "Mmm." He said. "It's delicious. You did a good job." He smiled warmly, he wasn't able to keep down his joy about Meredith feeling better. It was ... "Thanks. I will clean this up, no worries." She said, she looked mortified by the made she caused with her baking. "It's okay. I just came to shower and some clean clothes. I'll be gone before you notice." He said and with that, he disappeared. After he had showered, he grabbed some clean clothes. When he was finished, his pager whirred.

Damn, where did he place that thing? After searching the whole room, he found it on the nightstand. It had been a really easy position to locate. But even things this simple ... He feared the worst when he looked at the little screen. He held his breath and released it when he knew that everything was okay. They were paging him because they were ready to extubate. A smile formed on his lips when he read the message.

Derek was back from her house. He had showered, had a decent meal and was now back at the hospital. With Meredith. The ventilator only assisted her breathing. Meredith did all the hard work herself. That could be seen on her improving sats. When Dr. Burke came in to check on her, he noticed the low usage percentage of the vent and then he decided it was worth a try to get her weaned off of it and see if she will do it on her own. "So, Grey. Your condition really has improved since I have been here and I think we could extubate." He told her. Cristina responded at first: "Well, that's great news." Derek nodded, he was at a loss for words. They were finally able to extubate her. She would be breathing on her own in the next minutes.

Meredith tried to smile. She was happy it was coming out. Very happy.

He checked vitals and breath sounds and then said: "Meredith is ready to be taken off of the ventilator. Prep for extubation." He said to a nurse. Then she left the room and came back a few minutes later. Meredith was happy about that she was being extubated. Cristina and Derek were happy too. Finally, they were ready and prepped for extubation. "When I remove the tube I want you to breathe out when I start removing it. On my count ..." Dr. Burke told his patient. His hands were in sterile gloves that she saw. Then she concentrated on breathing. Meredith blinked to show him that she understood what he wanted from her. Cristina looked at the monitor, staring at it. She looked for any changes in the heart rhythm or oxygenation.

"One ... two ... three." He counted loudly and slowly and carefully removed the endotracheal tube.

Meredith prepared herself for what was coming but it was uncomfortable either way for Meredith but she got through it. She coughed after the tube was out. When she tried to talk, her voice was raspy and hoarse. Her throat was still sore from the intubation. But it would go away sometime soon. She was sure about that. She took a few deep breaths then focused on the people standing around her bed. She blinked. Once. Twice. Then the fuzziness cleared up and she saw Cristina, standing there next to her bed. She had her hands on the bed railing, squeezing it hardly so that her knuckles turned white.

She was nervous. Worried. Derek was standing on the other side of the bed, tightly he squeezed her hand. Meredith just lay there, she was trying to gain some more strength. "It's okay, Mer. You don't need to talk yet." Meredith nodded slightly, breathing in and out. Then again. For a moment, she felt the sudden urge to sleep but she fought it off. She wanted to stay awake. She had been out the last few days. She breathed. Felt that everyone was watching her do it. All on her own. The disconnected vent had been turned off. The ventilator was still standing there, resting, underneath her heart monitor. She didn't need its support any more. Unused. Done. Finished.

* * *

In Seattle Grace Hospital, Dr. Miranda Bailey and Dr. Addison Montgomery were talking to the distraught parents of Molly Grey- Thompson and grandparents of her daughter Laura. But it wasn't them they were talking about. It was another young woman and Molly and Lexie had never met her before. "Mr. Grey, can we talk to you for a second?" Addison asked the father of her patient. They were standing outside of the patient room. "What ... why? What is going on?" He asked back, fear sounded in his voice. "What is going on?" Susan, his wife, joined the conversation with a frown. "Is something wrong with Molly? Or Laura?" She wanted to know, concern sounded in her voice. "No, no. It is nothing like that. Molly is fine and her daughter is fine too. I just checked on her before I got here." She answered, professionalism was evident in her voice. "What is it then?" The question lingered in the air. For a few moments, Addison stayed quiet. Susan and Thatcher Grey noticed the tension. He was shifting uncomfortably.

"Maybe it's better when I talk to you alone, Mr. Grey. Would that be okay?" She asked.

Susan nodded and went back to her daughter's room. She did not ask why she should go but she did it.

Thatcher shifted uncomfortably. He didn't know what this could be about. He has no secrets. Susan knew he had been married before. He had been married to Ellis Grey, the surgeon. But they didn't work out. "Were you ... I am sorry, but we have to ask, were you married before you married to Susan or had a girlfriend? It is really important. We need to know that." Addison finally told him what this was about. Thatcher looked at them in surprise.

"Why ... why are you asking all these questions?" He wanted to know, his voice shook. Immediately he remembered his time with Ellis. How they met. Their wedding. Ellis's affair with Richard. The moment she had told him about the baby. He had thought it was Richard's but now ... He wasn't so sure. "Just answer the question." Bailey said. "Yes, I've been married before." He confessed

.Thatcher Grey looked at her shocked. He couldn't believe what he was hearing. "What." He croaked, obviously surprised. "Why?" He asked, his voice shaking. "Why is this relevant?" He wanted to know. "Because one of my interns, Dr. Meredith Grey, supposes that you could be her father. She only has his name. Thatcher Grey, she said when she told me about it. Her mother raised her alone ..."

"So ... what you are saying is, that I could have another daughter?" He asked dumbfounded.

Dr. Bailey nodded. "A paternity test can tell us that." She explained. The man shook his head. "No no no, I cannot believe this is happening." "It's about a DNA test, or paternity test. However you want to call it." She then revealed. Pause. Silence between the three adults. Will you do it?" Thatcher didn't answer right away. "I don't know-" He answered, his voice was unsure. Bailey and Addison waited for him to continue.

"I don't know- I already have a family." But deep down he knew this doctor was right. He knew Ellis had been pregnant and he walked away from the responsibilty. He was ashamed of himself. Why did he do that? His thoughts raced. Suddenly, he said: "Okay, when?" Dr. Bailey looked at her colleague and searched for an answer. Addison helped her out: "As soon as possible."

Lexie was startled when she heard her father talk about to the doctors. She had picked up the words, and was shocked. My father had a secret. That it was now clear. Molly knew it? Your mother? Did the other of the Grey, who happens to be the same last name as she had. Grey. It was not a common name. She remembered another person had written one that the history of medicine: Dr. Ellis Grey, general surgeon and the renowned 'Grey-method' developed.

"Okay." She heard her father saying. "When do we have the results?"

She didn't hear what the doctors were answering.

Lexie had read in a journal about the procedure and heard about it at university. In addition, Ellis Grey was one of the first great female surgeons. Maybe there was indeed a connection between all the Greys. Lexie Grey. Thatcher Grey. Meredith Grey. Ellis Grey. Was that other Grey her sister? The half sister she never knew about? Lexie had so many questions that swirled around in her head and she did not answer to them. Lexie shook her head in confusion. She did not understood it, simple as that. She would confront her father on occasion so that she gets some answers.

Then she left, her stomach churned. Lexie swallowed hardly when she thought about what she had whitnessed. How can she visit her sister Molly and look at her and her mother and not tell them about what she heard. This was not a small thing, this was big thing. A very big thing.

* * *

"Do you remember what happened to you, Meredith?" Dr. Burke asked after he removed the tube that helped her breathe when she wasn't able do to it herself. Meredith's eyes remained closed. But her chest rose and fell steadily with each time she breathed in or out. "She sleeps." Cristina said softly, watching the small frame of Meredith lying there. A breathing mask strapped over her mouth and nose to make sure she gets enough oxygen. "We should let her." She said. Dr. Burke nodded. "It's best for her if she sleeps. When she's in pain she can adjust the pain meds with the help of the PCA pump." He instructed them before he leaves. "Hm." Derek responded, wiping his face with his palm. He suppressed a yawn.

"You should do it like Grey." He said. "Sleeping is good idea for you, too."

Derek did not respond. "It's gonna be long, the healing process ... You will need your strength, Derek."

Derek nodded. "I will sleep. Sometime." Burke frowned but did not say anything. Cristina and Derek were sitting there, watching Meredith sleep in a healthy REM sleep. Derek felt tiredness creeping up in him. Before he knew what was happening he fell asleep in his chair. It didn't seem very comfortable but Cristina didn't want to wake him as long as everything's running smoothly. He deserved some peace and quiet where he could sleep. Well, she just sat there. Looking at Meredith's face, imagining the scar that bisected her chest in two.

In general, the closure of the sternum using vigorous takes place, led through the intercostal spaces wire loops ("wire cerclages") after have been received by necessity in the mediastinum drainage systems. That is how they closed Meredith's sternum up, exactly using that technique. Cristina Yang just sat there, for hours and minutes ...

After two or three hours, maybe four, Meredith woke. Her eyelids slowly fluttered open open. Only Cristina and Derek were in the room and watching her sleep. Meredith didn't answer right away. Her throat was sore from the intubation. When she noticed that plastic mask over her face, she pulled it down to her chin, away from her mouth and nose. Now it rested in the crook of her neck. She breathed loudly, her fingers still clasped the cup of the mask.

After gaining some strength, she croaked after some preparation: "How are you?" She breathed noisily.

"Meredith?" Derek asked.

"You asking us how we are?" He said thunderstruck. He wondered how she could do that. Disbelief sounded in his voice and Cristina escaped a muffled sound as she stared at her friend in awe. That could only do Meredith.

"We were worried sick about you, I am not even sure where it's safe to touch you - and you want to know how we are?" He exclaimed. Meredith smiled weakly and took a deep breath, then: "Won' hurt me. I have my good old friend morphine." She answered, referring to her appendectomy a few months ago.

"Excellent stuff." Cristina agreed.

"But you should leave that thing on." She said. "Your pulse oxymeter will start whining soon because there is no way that you're getting enough air on your own yet. She should leave the mask on. It is just for support." Meredith nodded, but didn't make a motion to pull it back on. So Cristina resettled the oxygen mask over her mouth and nose.

"You remember what happened?" Meredith looked between Derek and Cristina in the room. Why were they staring at her. Then it came back. The memories. "Yeah, I ... re ... remember." She finally croaked. Her eyes closed for a minute and she fumbled for the PCA pump. When she found it, she clicked it. One. Two. Three. Four. Four times. Then she leaned back. Derek smiled happily. His Meredith was awake and responsive and she remembered what happened. Relief flooded through his veins and he let out a breath he didn't knew he was holding. She remembered the surgery, what happened after the surgery ... She remembered.

"I could hardly breathe. I remember." Meredith told him in quiet voice, her throat was still raw. She closed her eyes for a second, then she opened them again and looked at both of them. "I couldn't breathe. It felt like my lungs were on fire or something, they just wouldn't do the work the wanted to ..." Meredith told them with a barely audible voice. In order to hear her, they have to be very very quiet. So they just nodded and waited for her to continue.

"I only remember bits and pieces." She continued.

"Can you up the bed a bit?" She asked Derek who immediately reacted. Without a word, he pressed a button on the side of her bed. When it was comfortable for Meredith, she said that it was good. Derek stopped pressing the button and sat down on the visitor's chair. "The stabbing pain was unbearable but the most time I was out. I don't ... remember what came after that. Everything was just so blurry. And then the incision that also hurt." Meredith whispered, taking a deep breath.

"It was hard. Then, nothing. I was out."

"For a few days." Derek nodded. "I love you, Mer." He said.

"I love you ..." She mouthed towards Derek, who replied with a kiss on her cheek.

* * *

_Post- op day eleven:_ "Now I have a scar. Will you still love me despite this horrible scar on my chest?" Meredith asked him. Her voice was serious but her eyes were showing that she just asked for fun. Derek smiled and kissed her on her mouth before he answered Meredith's question. "This scar ... because of this scar you will live. I have not lost you. That means everything to me, Meredith. You are the the love of my life and a scar won´t change that. Never ever. Even with scars you´re beautiful." Derek assured her, happy that his girlfriend was out of surgery and her vitals were great. Meredith giggled but stopped when she discovered that her ribs hurt which was to be expected after open heart surgery.

"Ouch." She grimaced. Derek looked at her alarmed. "Are you ... Is everything okay ... do you want more pain meds?" He asked worriedly. That made Meredith smile but she said no. "I just need you. If I wanted more of them I just need to hit the PCA pump, you know." Derek kissed her on the forehead. "I know." He responded, a deep sigh was escaping his lips. "I just worry about you. I hate seeing you in pain and that I can't do anything about it." Without saying anything, Meredith took his head into her hands and kissed him right on the mouth.

"Wow." Derek got out when they as they separate from one another. He drew a deep breath. "I know right?" Meredith asked him, she knew he was thrilled how much energy she had. "I am the one with the fixed heart. Now I can do this without having trouble breathing. I can do what I want. I know I should follow directions but screw it. You only live once." She said, thinking out loud. She knew Derek didn't like the part with the screw following directions, but she didn't mean it. When Derek looked at her with a shocked expression she rolled her eyes and said: "Relax. I was just kidding. Of course I won´t so anything that could somehow endanger my live, I got it, Derek. I am a grown woman."

"Well, you stuck your hand in a body cavity with living ammunition in it. And you almost got blown up because of that action." Derek reminded her.

"I know it was stupid but I had to do what I had to do to save the patient. He had kids, Derek. Why are we even talking about this?" Meredith asked, tried to sit up but groaned when her chest wouldn't allow her to do that movement. "Are you okay?" Derek asked alarmed. "I am fine." Meredith replied, still trying to breathe as shallow as possible so that it won't hurt that much. But with each minute that passed, the feeling in her chest disappeared and Meredith relaxed. "You sure? I don't have to get someone? See if it's infected?" Derek reacted a bit panicky causing Meredith to chuckle. But this time it did not hurt. She was glad about it. "It is not. If it was, I would definitely know it. I am a surgeon too, even if I am still in training."

"You said it." Derek grinned when he looked at Meredith, who looked so much better than before the surgery. The pacemaker really was working. "Okay, Mer. I really need to shower. And food. I am starving." "Go, Derbear, do something for yourself. You have been taking such good care of me since all of this began ..." "I will be back in four hours, give or take. I love ya." He said.

"I love too."

Meredith was bored out of her mind. Hospitals are boring when you are a patient, there is nothing you could do. Then Dr. Burke came to check on her. What a welcomened surprise. "I came here ... " Meredith cut him off: "... to check on me or / and my incision. I am doctor. I know how it works." He just grinned, but did not talk. But then, "You sure do."

"I sure do know how this works." She parroted.

"Incision looks good. It is healing properly." Dr. Burke said after he examined the surgical scar. Meredith scoffed. "That's good, Grey." He smiled when he covered it so it was safe from bacteria and any other germs- "But it is clearly visible. I'll never be able to wear a bikini." "I did not wanna know that, Grey." Burke responded. "You had a scar before this surgery." "But it wasn't that visible before the surgery." Meredith argued back. "I have to work Grey and you have healing to do." He answered. Meredith frowned and watched the surgeon leave her room. "But I have nothing to do. I am dying."

"You are not."

"I am. Because of boredom."

But he only laughed. Meredith pouted. "I'll send Cristina to prevent that." He said, before he left the room. "That was the answer I wanted to hear." Meredith said, happy that her surgeon was being cooperative.

About five minutes later, Meredith already feared that Burke had forgotten what he had promised, she heard footsteps coming nearer. Hopefully it was Cristina.

"Burke sent me here."

Suddenly Cristina was standing in the room. Meredith's face lit up when she saw her friend. "With a really weird reason. He said something about you dying due to boredom. Is that even medically possible?" Cristina stated, moving closer to the bed. "You're here, finally. Living in the hospital is downright boring, there are no patients or anything. Just a bed, all the noisily beeping machines that are ought to drive you crazy while monitoring your vitals, no offence- but I really miss being in an OR, learning some new techniques." "Meredith …" Cristina tried to stop her patients rambling. "Plus, daytime television sucks. I miss being an intern, being here as a doctor." Cristina stared at her in amazement.

"So you actually called me to come down here to talk about how much daytime television sucks." She stated bluntly.

Meredith nodded while Cristina released a designated sigh.

"Well, maybe you have time to visit me. I sent Derek home to get a shower and eat and sleep." Meredith explained. "Also, these chest tubes, when do they come out? Any time soon, I assume?" Meredith sounded desperate. "Uh, I don't know. That depends on how much fluid still gets collected in the chamber, Mer and you know it." Cristina let herself fall on a visitors' chair. "I don't even know what rain on my face feels like. I've been here forever and this sucks." Meredith complained. "Why me?" She then asked. "Why me?" She repeated. Cristina had no idea. "I don't know. Weird twist of fate?" She offered.

"Shut up." Meredith grumbled.

"You're supposed to be doing the whole being supportive thing.

"Well, I am not. So just stop whining and suck it up. You can't change a thing anyways so why bother racking your mind for an answer you're probably not gonna get." Cristina told her straight out.

"Go to hell." Meredith gave back exasperated.

Cristina just shrugged and Meredith leaned back. "That's the Meredith I know." She just added a few minutes later. Meredith only rolled her eyes in reply which led Cristina to letting out a chuckle.

* * *

_Post- op day fourteen:_ Meredith was stable enough to be moved down to stepdown unit. And she was more than happy about it. No more annoying catheters, just i.v. Access et cetera and the cardiac monitor. She still was a little weak from the infection but the antibiotics started working and kicking the infection´s ass like Cristina would say. Cristina was here, updating patient charts and because she wanted to spend some time with Mer, she decided to do them here. That way, she can work and spend time with her best friend.

"You don´t have to ..." Meredith said while slowly sitting up, followed from a small groan.

Cristina looked up, she saw the pained expression on Meredith's face.

"Don´t ask me if I am in pain. I am not." Meredith said, already knowing what Cristina thought. "Are you? Or isn´t your PCA pump working?" She asked, pointing towards the little thing where Meredith can admister and adjust her pain meds after her own needs. "Don´t you have something to do instead of questioning patients lying in CICU?" Cristina's face

"So, Grey, we are about to move you. Are you excited?"

"Excited of getting out of here." Meredith replied, she wrinkled her nose. Dr. Bailey laughed. "Well, it may take awhile before I can let you out of here. Three weeks minimum, four to five weeks maximum." Meredith grimaced. "Really, and there is no way I can negotiate?" She asked back. Dr. Bailey's lips twitched deliberately. Meredith laughed as the surgeon ordered two nurses to prep a room for her in stepdown unit.

Now it can only get better ... The worst was over.

* * *

_**A/N: Well, now there is Lexie in the mix too. It's getting interesting. If you want to find out what Meredith and the others say when the results of the paternity test are in? How will they all react to the news? How will Meredith, will she agree on meeting Thatcher? And her half sisters? There are a lot of possibilities and changes ... Now there is a lot of family drama. Grey- ish family drama. I hope you like this chapter ... I will post the next chapter as soon as possible.**_


	22. Chapter 22

**Chapter 22**

* * *

**In the practice of medicine, change is inevitable. New surgical techniques are created. Procedures are updated. Levels of expertise increase. Innovation is everything. Nothing remains the same for long. We either adapt to change, or we get left behind. Change, we don't like it. We fear it but we can't stop it from coming. We either adapt to change or we get left behind. It hurts to grow. Anybody who tells you it doesn't is lying. But here's the truth: sometimes the more things change, the more they stay the same. And sometimes, oh, sometimes change is good. Sometimes change is everything. **A Chance Is Gonna Come

* * *

_Post- op day fourteen:_ Meredith was stable enough to be moved down to stepdown unit. It meant she wasn't in the need of constant medical observation. That was good. Nobody had been talking to her yet but she heard Bailey and Burke talking about it on the floor. They didn't know she heard them. And she was more than happy about it. No more annoying catheters, just i.v. access et cetera and the cardiac monitor. She still was a little weak from the infection but the antibiotics started working and kicking the infection's ass like Cristina would say. Cristina was here, updating patient charts and because she wanted to spend some time with Mer, she decided to do them here. That way, she can work and spend time with her best friend. "You don't have to ..." Meredith said while slowly sitting up, followed from a small groan. Cristina looked up, she saw the pained expression on Meredith's face. "That's you not being in pain." Cristina commented. "Are you really that stupid? Take something for it." "I am not getting hung out on pain meds." Meredith shot back. "But are you in ..." Cristina began to ask.

"Don't even think about asking me if I am in pain." Meredith said, already knowing what Cristina thought. "I am not."

"Are you? Or isn´t your PCA pump working?" She asked, pointing towards the little thing where Meredith can admister and adjust her pain meds after her own needs. "No. I know when to use the PCA. And as sure as hell I don't need painkillers. I am not in pain." Meredith argued back. "Hm." Cristina didn't sound very convinced. Don´t you have something to do instead of questioning patients lying in CICU?" Cristina's face expression didn't change at all. She was prepared for this. "I have charts to do and since you told Burke you'd die because of boredom ..." Meredith rolled her eyes but didn't say anything. "... I decided to do them here and prevent that from happen." The sound of the heart monitor could be heard.

"You are a nice girl." "Yeah, yeah." Cristina replied.

"But since I've finished this, maybe ..." But Meredith interrupted her.

"Are you already studying for the intern exam?" Cristina looked at her friend in awe. "Wow." She said.

"What?" Meredith shot back. "Why do you say wow? What is so wrong about that question?" Meredith wanted to know, wincing when she made a sudden move. When are these chest tubes coming out, they are annoying and they hurt like hell. Luckily, she wasn't one of those people who reacted very sensitive to chest tubes. Then it would be hurting a lot more than it already does. The painkillers seem to be wearing off, absentmindedly Meredith reached for the PCA pump and clicked it once. Cristina looked up, she didn't say anything but she hadn't to. Her face says it all.

"Nothing. Nothing is wrong about the question. It's just that you, barely two weeks post- op major cardiac procedure, are already thinking about the intern exam. Isn't that a bit early?" Cristina replied, shrugging as she explained. "And that is coming from you, I don't believe it." Meredith answered. "I want to be the best." Meredith revealed. "You don't want to challenge me, I am unbeatable." "If you say so, I mean I can and I want and I will challenge you. So, are you already studying for it, I don't want to be behind all of you." Meredith said.

"Calm down, it's fine. I am already learning for the intern exam whenever I can." She answered. "But since your surgery I haven't had the time." She added. Meredith ignored the last sentence very wisely.

"Can you bring me some medical books or maybe flashcards? Maybe even Callie's, I heard hers were pretty detailed- Then I could spent my time recovering with something more useful than just lying around and die because of boredom-" Meredith really loved that quote. Cristina laughed and answered: "You won't die. We've already discussed this, and I won't go over it with you again." Meredith didn't reply, then after a few minutes, she said: "I wasn't talking about that, I was talking about the intern exam. There is no way I will get left behind with all the medical stuff, I will be kick all of your asses when I get out of here and I will kick this test's ass. So now would be good time to start studying, don't you think?" "Yeah." Cristina responded.

"So it's gonna be a competition?" Cristina asked. "Just you and me?"

"You bet it is." Meredith answered with a sly smirk on her face. "Just the two of us. It's good, when we push each other to make us better than we already are. Together, we can push boundaries." Meredith said to no one in particular. Cristina chuckled when she heard what her person said. She was right, they pushed each other to be better than all the other interns.

"First you have to get out of here."

"I will, don't worry." Meredith assured her person.

Suddenly, a soft knock on the door interrupted the bickering of the two. "That is not Bailey, you want to guess?" Cristina said. "Probably not, why." Meredith replied. Again, someone knocked against the door. This time, Meredith called loudly: "Come in. Whoever this." The door was being opened. By someone named Alex Karev. "Alex." Meredith exclaimed when she saw her friend. "Hey, evil spawn. What are doin' here?" Cristina asked him, laughing. Alex knew didn't mean it and was just teasing him. "Why is she laughing?" He points towards Cristina.

"I have no idea, honestly." Meredith answered, watching her person attentively.

"Why are you here ..." Meredith asked, facing Alex. "Not that don't like it, but I am wondering why you and Cristina are the only ones who bothered to come by sometime ..." The question hit him like a tons of bricks. He really should have come sooner, he scolded himself silently. He wasn't sure if he was wanted there, he was unsure about it and then, it just happened. He smiled cockily but it was soon replaced with an honest and real smile. "I am sorry I haven't been here." Alex apologized quickly and sent her an excusing gaze, Meredith replied with a soft nod. She knew what he meant. Alex shifted and entered the room, before he stood on the doorway and tried to decided whether he should enter the room or not.

"Come in." Meredith told him, when she was noticing him still handing there and unsure of what to do.

"How have you been?" He asked Meredith, worry covered his face. "I am good. Thanks, though, for asking." She paused, gazed at him for a few seconds. Then she added quietly: "Thanks."

"For what?" Alex asked, he partout didn't know what she meant. Meredith looked at him with her blue eyes and tried to find the right words: "I ... I was told you were the one ..." She trailed off, still looking directly at him. Alex suddenly knew what she meant. "... who found me. Thanks, Alex for being my hero. I just ..." She didn't know what to say. She was so thankful for being alive and it was partly because of Alex. "I am not a hero, Grey. McDreamy, he is the one. I am just the one who protects you when you need protection - like a big brother." He replied, meaning everything. Every word he had just said. He meant every single word of it.

Meredith didn't know what words she shuld use, that were able to fully convey how thankful she was to be alive. "It wasn't just me." Alex then said. He was feeling awkward when she told him how thankful she was. He doesn't these kinds of feelings or something. It was all new to him.

"It was Mark too." He added. "I didn't know ... I am sorry ... I should have thought sooner about that." Meredith whispered. "I haven't thanked him yet, I didn't even know he was with you." She sounded ashamed, but why was she blaming herself? She didn't do anything. They all knew she was in a position that hasn't made it possible to talk or thank people. "Meredith. Look at me." He said, grabbing a chair and sitting down next to her bed. Damn, why did he say that at all? Was he really that much of a jerk? Why did he do this? Alex couldn't not think about what he should have done different. It was wrong to tell her then. He decided to stop her from blaming herself before it really begins.

So he starts talking to her in a gentle, quiet voice that is ought to calm her down and convince her that she shouldn't blame herself for not saying thanks. "It's okay, Mer. Don't start blaming yourself for this, you weren't in a position that allowed you to thank anybody. You don't have to apologize, there is no reason for it, okay. Don't do this to yourself. You need to focus on your recovery. You need to get back here as soon as possble and kick all of our asses."

"I'll try." Meredith said, a small smile covered her lips. "I'll try, really. I promise."

"I am here because I wanted to see myself how you're doing. You know, it didn't look very good at first ..." "That is what they keep telling me." Meredith interrupted, chuckling.

"Why are you ... I don't get it." Alex stated when he saw the twisted sisters laughing, both of them. "Doesn't it hurt with all the chest tubes and everything else, I mean they did divide your sternum ..."

"Oh, yes, it really friggin' hurts." Meredith answered, still continued to laugh. Alex just looked at them uncomfortably and tried to figure out why the were laughing. "Then why do you do it?" He asked. Trying to make sense of what they do but he just couldn't. He shook his head and waited for an answer. "Because it's funny." Meredith said, still laughing. "Everybody just keeps saying that it has been hard and it didn't look very promising. But I don't know why." "Maybe you should ask her." He pointed towards Cristina. "She's been there the whole way. Bailey made us others go home. Even resisting didn't help." He told her. "I can imagine." Meredith replied. "You should really ask your person. She's knows the reasons."

"She does?" Meredith made sure she heard everything correctly. "She does, she was with you. Shepherd's knowing it too. She just kept us others in the dark. I only know because Cristina told me. Izzie and George, I don't think they know." He said.

Cristina stared at Meredith's heart monitor.

"Hey, Yang, there's no need to stare on this monitor. She's stable, her heart's rhythm is like it should have been from the very beginng. Then we wouldn't have had all these encounters with ..." He trailed off. It was subtle innuendo coming from him. "Cristina, how many days have I been here?" Meredith asked. "How many do you guess?" The korean doctor asked back. Meredith silently counted in her head. "I have no idea. Maybe seven or eight days?" Silence, no one spoke. "Guys, what the heck is going on? You are acting all weird and still don't know what happened. I remember it kept on getting harder to breathe but the feeling like my torso's been on fire but I don't know why ..." Cristina avoided her questions. Alex cleared his throat. That was Cristina's part to say. "So I need you guys to start talking to me, I need some clarity."

"It was pneumonia." Cristina finally told her.

"It has been fourteen days, Mer. You're at day fourteen post- op." Meredith looked at her as if she didn't believe her. Fourteen days. She'd been in Cardiac Intensive Care Unit for more than two weeks if you the days she spent there pre- op. Cristina knew Derek would be pissed off when he knows that she had told her but she ignored it, instead she watched Meredith's reactions. "What? You are kidding, aren't you?" Meredith exclaimed.

Pneumonia, that would explain it. It was perfectly quiet. Meredith stared against the cold, sterile wall and seemed to be in her own world. "How many days was I out?" She asked, with a quiet but demanding voice. She wanted some answers. There was no need in sugarcoating her, she was working here, she knew the post- op protocols and she also knew all possible post- op complications. Nosocomial pneumonia was one of them. And since it was mostly late- onset pneumonia, it's more likely that the patient doesn't respond to regular antibiotics due to the whole multiple drug resistance thing. All these facts were playing in Meredith's head.

"About seven days, Mer. It was a long time, Derek was totally wrecked. He was a mess, skipped meals whenever he could 'til Bailey threatened to give him an infusion. Burke basically had to drag me home, I spent the nights in some on-call rooms worrying. It were seven days, that's quite a long time. We had to put you back on the vent, to get your low oxygen levels under control, hell, even your blood pressure was tanking and on top of that you needed blood transfusions because your Hb wouldn't resolve itself." Cristina told her the whole truth. Meredith didn't realize it had been that bad. "I didn't know ... that it had been that bad." "You were out for the most time, so there isn't very much you possibly could remember anyway." "I'm sorry for doing this to you, I am ..." Meredith responded quietly. "Meredith, don't apologize. There is no reason for you to do that." Alex said.

"But I caused you so much trouble ..." Meredith's voice shook slightly when she said those words. Cristina flinched when she heard her friend talking like that. It wasn't her fault, she said to herself. It's not her fault she has a heart defect. It is not her frigging' fault, why doesn't she get that? Luckily, Alex had taken over, convincing Meredith that it wasn't her fault that she's been born sick.

"Doesn't matter, you're alive and that's what counts." Alex countered.

"Thanks." Meredith smiled relieved.

* * *

Lexie had been in Seattle for six days. She had visited her sister Molly a few times who was very pleased and happy to see her older sister, not knowing that Lexie was the Middle Grey. She didn't know about Meredith who seemed to be their half- sister and Thatcher still didn't told them about what was going on. Lexie did not like that, she wanted to know how things were going, if they would be able to meet their older sister ... But now? Molly did not even know Meredith existed. Now was the day they were going to discharge Molly and Laura soon, tomorrow maybe. Lexie was sitting on a chair next to Molly's bed. Molly held her sleeping daughter in her arms and watched her sleep. Then her gaze slid over Lexie who seemed to be in thoughts. "Hey." Molly said softly. Lexie flinched when she heard her voice. Not because she was scared, no, she just didn't expect it. "Hm. Oh." She said, looking at her watch to see what time it is.

"What's up?" She then asked. Molly looked at her older sister. There was something on her mind, she had a feeling there was. She and Lexie had a special bond between them and they knew when one another had something on her mind. This time, it was Lexie. She wasn't like she usually was. She changed. Maybe something happened at medical school, Molly assumed but deep inside she knew it had to do with family. "Lex." Molly repeated meekly and patiently. "What is going on with you?" She asked. "What do you mean? I am fine." Lexie replied with a frown and then suddenly the older Grey exclaimed perkily: "Oh, she's so sweet. I think she has your nose." Molly looked at her sister attentive. This wasn't the Lexie she knew. But she didn't say anything and so Molly decided not to ask. Maybe she will in the near future but now she was just happy that her sister was here to see and meet her niece.

"Do you ..." Molly bit her lip. "Do you want to hold her?" She asked.

"What?" Lexie looked at Molly, searching in her face expression for evidence that she had heard everything correctly. She had heard everything correctly. Molly was offering her to hold her. "I mean it, Lex. You really need to relax. Just hold her, you'll see." Molly assured her smiling. Lexie nodded and carefully Molly positioned her little one in Lexie's arms. Then she leaned back in the pillows and closed her eyes for a second. Then she watched Lexie playing with her niece. The sleeping baby was wide awake now. Her big blue eyes were focused on Lexie, who smiled and in this moment, Molly was sure that the baby was safe in Lexie's arms. Of course, her sister is about to become a doctor, she almost finished med school and knew how to hold a baby so that the head isn't being hyperextended.

"Okay, now that you have calmed down a bit and aren't that jumpy anymore ... can you tell me what happened?" Molly asked. "Did someone attack you? If yes, you can tell me ... But, please just say something." Lexie shook her head, Molly was jumping to the worst possible conclusions for her confusing behavior. "No, it's nothing like that." Lexie told her sister, who was looking at her searchingly. "What is it then?" Molly asked, continuing to look at her sister. "I overheard Dad talking to the doctor's." Lexie explained. "Lexie. What did you hear? Is it about him, is he okay? He isn't sick is he?" She asked alarmed, the baby in her arms immediately noticed the tension in the room and started to cry loudly. "No." This were the only words coming out of Lexie's mouth.

"He is not, actually." Molly breathed a sign of relief.

"Good, that's good because if he were I wouldn't what I am supposed to do. I've just had a baby and ..."

Lexie cut her off: "... emotionally unstable with hormones all over the place, I get it." She sighed loudly. "Should I go on?" She asked her younger sister. Molly just nodded. "Like I said, I heard him talking to the redhead who delivered Laura." "Addison Montgomery, she was the one who did it." Molly said, cutting her off, "But what has she to do with our father." That's a pretty good question actually." Lexie said.

"And I know the answer. I keep thinking about confronting him, to make him tell me what is going on ... but I have no idea if I really want to know. We might have an older sister, Mol." She blurted out.

"What?" Molly cried out, she couldn't quite believe it. "We have a sister?"

"We don't know for sure yet but chances are we do have a sister." Lexie said. Molly was shocked. "Does Mom know?" Silence between them, Lexie made no attempt to answer. But she didn't have to, Molly knew that Lexie thinks their mother doesn't know about anything of this.

* * *

Dr. Bailey was in Meredith's room in CICU and held her patient file in her hands, checking vitals and monitors, also the chest tubes were getting checked to make sure they aren't clogged or kinked. Apparently, everything checked out okay. "So, Grey, we are about to move you. Your lung function has improved, your vitals remained stable and you are talking. Are you excited of being moved?" Bailey questioned, in her mind she asked herself if the thing with Grey had made her soft. In her mind was forming the realization that Meredith didn't need to be in the ICU anymore. Her recovery had progressed way past the acute stage. Intensive Care Units were for people that were immediately post- op, in critical condition or in need of constant medical observation. Meredith didn't meet any of those criteria anymore. Realizing that, Bailey had been relieved and talked with Burke about moving her and in the end they decided she'd been there long enough.

"I'd be even more excited to get out of her. Excited of getting out of here. I've been here long enough, too long for my liking." Meredith replied, she wrinkled her nose. Dr. Bailey laughed. Maybe, it did, she thought but before could deepen it she had other things to do, like getting Meredith moved to stepdown unit. "Well, it may take awhile before I can let you out of here. Three weeks minimum, four to five weeks maximum." Meredith grimaced. "Really, and there is no way I can negotiate?" She asked back. Dr. Bailey's lips twitched deliberately. Meredith laughed as the surgeon ordered two nurses to prep a room for her in stepdown unit. Now it can only get better ... The worst was over.

"So, are you going to answer my question, Bailey?" Meredith pressured her resident.

"No, Grey, there is no way you can negotiate." Bailey answered. "You could try but I don't think that that would help matters. I mean you gave us quite the scare, Meredith." She called her intern by her first name. "Oh, C'mon, Bailey. This ..." She made some weird gestures with her hands. "This is getting old." She told her. "You telling me that I scared you- which may be right but I know when I am feeling okay and when not. So really, is this your last word?" Meredith asked. She wanted out of the hospital. She was sick of lying around here, being completely useless. "Enough of that. Where's that dreamy boyfriend of yours? Did you sent him home?" Bailey asked. "Maybe he listens to you more than he does to me."

"I did." Meredith's eyes twinkled when she told her how she got Derek to go home and sleep.

* * *

**Meredith Grey, nine years**

_Meredith Grey didn't have many friends. They were afraid of her being contagious which was idiotic because first of all, heart defects are congenital not infections ... but they didn't know that. One of them was this korean girl that lived in the same street as her and her mother for like three years, then they suddenly were gone. Disappeared. Meredith never knew what exactly had happened. She had been nine years, the girl had the same age. They met when Meredith was six years old. The girl's mother always called her 'Crissy' but Meredith was told by Cristina (that was her real name) that she should call her Cristina. She hated nicknames like Crissy. They were girly. That's what she said and wrinkled her nose. They met when Meredith and Ellis moved to Boston.  
_

_Meredith had laughed with her about that. She had the same opinion. Crissy sounded weird but she liked Cristina's real name. They met often, regularly. She often went over to Cristina's house right after school when Ellis worked long shifts and she didn't find a sitter. Then her mother sent her to Cristina's family that welcomed her in their home whenever Meredith was there. Luckily, she and Cristina had the same interests.  
_

_She had even told her about her heart defect. Or at least, she mentioned it to her. "Cristina, I ..." She started. Cristina looked up from the paper. Next to her were some crayons in different colours. Meredith looked at what her friend had painted. "What's this?" She asked. "Look for yourself." Cristina just answered. Meredith stared at the paper. She had painted a heart. A heart that looked like the normal human heart. Of course there were some anatomical __inaccuracies and errors but all in all it looked like a human heart. Meredith could easily identify the aorta (many perks of having a mother who is a surgeon) and then she said: "How do you know that?" She really wanted to know where she got all her knowledge about human anatomy.  
_

_Cristina grinned and said: "Anatomy books." Meredith couldn't help but ask: "For children? And your mother allows that?" "She always freaks out. She wants me to read the normal things girls my age read - you know, the horse and pony thing. That's what she wants me to read." Cristina grumbled. "But you read them anyway." Meredith concluded. "I do." Cristina answered, laughing. Even though it freaks my mother out. My dad likes that I am interested in medicine ..." She trailed off. Meredith looked to the ground. She didn't know her father, he left before she was even born._

_Cristina noticed the sudden change in Meredith's behavior. "Did I say something wrong?"_

_Meredith shook her head._

_"I have no father. Mine ran away before I was born. I never ..."_

_"Oh."_

_Cristina looked filled with consternation. "You are lucky to have both parents." Meredith continued: "And you're lucky to have a normal heart." "There are unnormal hearts?" Cristina asked back. "Is that some kind of medical condition?"  
_

_"It is." Meredith answered._

_Meredith thought she would make big eyes and then run away because she thought it is contagious but instead of doing that, Cristina just shrugged and replied: "As long as you live, I don't care. I wanna be a doctor, you know." "My mother is one. A surgeon." Meredith said proudly. Cristina's eyes lightened up when Meredith said that. "Really? Your mother is a surgeon?" She asked. Meredith secretly wondered how she could possibly know that there was something like surgery.  
_

_"She is." Meredith confirmed. "Wow." Cristina replied. "I know. She's always working long hours. That isn't very great but it's okay. We do the fun things on the weekend, then, when she gets some time off." "I wish my mother would be a surgeon. She decorates houses." Cristina told her when they were in the garden behind their house. "Decorates houses?" Meredith asked, she couldn't figure what she meant with that.  
_

_But suddenly, Cristina was gone. They were moving away, somewhere to another place. West Coast. Not Seattle, but Los Angeles. Why they moved Meredith didn't know. She did not have an address to contact her friend. Even though Cristina is gone (She is in another city, not dead!) Meredith still considered her as her best friend. A real friend. Before they moved, Cristina said goodbye to Mer and then she left. But she didn't say why they were moving. And even less, why they were moving ... She had no ideas.  
_

* * *

"Derek, I need to talk to you." The cardiothoracic surgeon said.

"Let's go outside so we won't disturb the patient." He motioned to Meredith Grey. Dr. Burke entered Meredith's room in CICU. Derek looked up, Meredith wasn't awake right now. She was asleep. What he didn't know was that she was minimally conscious but didn't want anybody to know. "What's going on?" Derek asked. "Can we talk in here? I don't want to leave her side." He explained. Meredith just listened to them with closed eyes, they still thought she was asleep. "I need to check Grey's incision sites and we need to check if there is a dire need to let the chest tubes stay in for longer." Of course they had changed the tubes within the two weeks to prevent another infection.

"Is there a chance that you'll be able to remove them?" Derek asked, he sounded kind of exhausted.

Removing them?!

Meredith liked that they would come out but she knew that she procedure would hurt a lot, that it would be hell for her. She didn't remember the insertion 'cause they've been placed as she still was in the OR. And when they replaced the chamber and placed new tubes, she had been out. But now they were finally coming out. That was a huge relief. But it also left her little bit anxious about the removal and when she heard Derek and Burke discussing, she wasn't the only one.

Derek was anxious about that as well.

"Yeah, a good one." Burke answered after checking her respiratory status which was good. No shortness of breath, and after listening to her lungs he knew that she has bilateral breath sounds, plus there was a symmetrical rise of the chest on inspiration. So everything was looking good for now. She met the indications for chest tube removal. "Respiratory rate is less than 24 breaths per minute so that's good as well."

"So she is doing great. And she is ready for tube removal?" Derek wanted to check for a second time.

"Yeah, she is ready for tube removal. We can safely remove it when the drainage is 200 ml in 24 hours. If blood precipitated tube insertion, minimal output and a change in drainage from bloody to serous or serosanguinous it is also key indicator." He explained to a distraught Derek.

"So what you're saying is that she is ready now." Burke only nodded.

In the case of pneumothorax, the tube can safely be removed when bubbling or fluctuation in the water-seal chamber ceases during expiration or during a cough. He was facing his colleague who was now here as a worrying family member. Derek nodded. "But it will hurt." He noted, glancing over to Meredith who still seemed to be asleep.

"I am not going to lie. Yes, it will hurt."

Derek exhaled deeply, hating the idea of Meredith being in pain. But in this case, there was no other way.

"Can't you give her something or up her dose that will take care of her feeling any pain? I don't want her to be in pain. This is woman I love, I want to spend the rest of my life with." Derek argued back. "I know what I am doing, Derek. You just have to trust my skills. We can't give her any more than she already has gotten, she's maxed out. Plus, we've already had trouble with stabilizing her BP at all since it was always on the low side and this wouldn't have a good effect on that. So, we can't use any strong pain meds. We can give her a sedative though." Burke suggested.

"That would knock her right out before we're doing the procedure. Would that sound okay?"

But before Derek could respond to that suggestion in any way, Meredith cut into the conversation. In surprise, when he heard her voice he looked up as he stumbled backwards. "No … sedat … sedation." Meredith interjected, breathing slowly in and out. "Grey, you're awake." Burke stated as he looked into the opened eyes of Meredith Grey. Derek walked over to Meredith's bed and leaned forward to place a soft kiss on her forehead. Meredith smiled at him for moment she was lost in his eyes.

"How much did you hear?" Derek asked quietly.

"You being … worried about pain … you love me … something about low BP … sedatives … I meant it … no sedatives." Meredith was stubborn as well.

"But Meredith …" Derek attempted to protest. "I am rather alive and in pain instead of dead and in no pain. This pain will fade, Derek. At some point it will go away." Meredith assured him. "I still don't think … that this is what you want. I am being honest with you, this is gonna be painful and exhaustive for you and your body. So it's better to sedate you while we remove the tubes. It's for your best, Mer." Derek tried it again. Meredith held up her hand as a shushing gesture. It silenced Derek. "I don't want to be foggy. And it's my right to refuse the pain meds." Burke looked back and forth between Derek and his patient. "You sure, Grey?" Burke asked with curiosity in his voice. Meredith said silently: "Yeah, it's what I want."

"Ok, then that's how we do it." Burke said to Meredith.

"I'll be right back with a nurse and the supplies." That's when he left the room. Derek sat down on a chair next to her, softly caressing her cheek to distract her from what is going to happen soon. "Okay, before we go any further, Meredith, I need to do a chest x-ray prior tube removal to confirm re-expansion of the affected lung and to assure that the timing is right." He explained while he clamped the chest tube before obtaining the X-ray, which simulates its actual removal. If the patient's lung is fully expanded, he won't develop respiratory distress when the tube is actually removed. Meredith turned her head to Derek who nodded slightly as if he wanted to say: I am here. I am not going anywhere.

"You know, this'll only take seconds, the actual removal, I mean." Derek tried to ease her and his mind and they both knew it. In that moment, Cristina walked through the door with a shocked face expression. "You're doing this without being pre-medicated? Are you freaking crazy, Mer?" Meredith looked up at her friend. "Burke, I met him in the hallway and he told me what he was going to do and that you're refusing sedation. Meredith …" Cristina shook her head. "I already tried to tell her that." Derek offered sadly. "She won't take any pain meds."

"Stubborn." Cristina mumbled under her breath.

"You're about to scream very loudly, Mer. You know that, right?" She asked. "Ignore her." Derek said as he flashed Cristina an angry look. "I don't want … to be … foggy." Meredith tried to suppress the need to cough 'cause that would result in stabbing pain in her chest due to the fact that her sternum has been divided.

Cristina seemed to ponder something then she plopped herself on another chair and said: "I am staying. You need someone to tell you 'I told you so.'" Derek threw her another angry look. "You're a good friend." She told Cristina. Then Burke entered the room again, this time with a nurse and the gathered supplies they need for the removal which are sterile gloves, goggles, gown, and mask, a disposable under pad, a sterile suture removal kit, Kelly clamps, gauze or Tegaderm dressing ready for application; and 2" wide occlusive tape. "So we're going to start with the x-ray." Burke started. "This is the easy part. I am going to inject a local anesthetic." Meredith closed her eyes after feeling a short sting of the needle entering her skin. After doing the x-ray, Meredith braced herself for what was to come. She didn't want this to be happening. This shouldn't be happening. Her x-rays seemed to indicate that removing them was the right choice and so they moved forward with this. Derek was holding Meredith's tightly to give her comfort.

The distinct beeping of the cardiac monitors could be heard.

"I'm starting." He said after placing her in a semi-Fowler's position, with a disposable pad underneath her on the affected side. The pad will protect the bed linen from drainage and fluid at the tip of the chest tube and provide a place to set the tube immediately after removal. He gently removed the chest tube dressing, and was taking care not to dislodge the tube in the process.

Meredith tried her best not to wince and Derek felt her stiffen.

She knew she had to do the Valsalva maneuver when Burke tells her too.

Burke was concentrated on what he was doing. An oxygen mask was covering Meredith's mouth and nose, providing extra oxygen. Meredith wanted it to not happen.

This whole thing shouldn't be happening. Derek was whispering soothing words of comfort. Cristina on the other hand was watching Burke's work closely. He now cut the sutures that held the chest tube in place. When inserting this, Burke had placed a purse-string stitch and now avoided clipping it, undoing the sutures he'd done. Although not absolutely necessary, a purse-string stitch is often added so that it can be pulled and tied down after tube removal to ensure closure of the wound. A purse-string stitch is likely to cause increased pain after chest tube removal. It also leaves more of a scar. But that was okay. Meredith tried to think of something else as she heard Burke say it before doing it.

"Removing the tube." Burke said, as he removed the tube in precise and quick movements to ensure that no air or contaminants are introduced into the pleural space, simply because that would be bad. As soon as Dr. Burke clamped the tube with the Kelly clamp, he instructed Meredith to perform the Valsalva's maneuver. Meredith's face scrunched up in discomfort as she tried to follow Burke's directions. "C'mon, Mer, you can do this, I know you can." At maximal inspiration, the tube will be gently but swiftly removed. This is the most reliable way to avoid allowing any incoming air into the pleural cavity. Then he did it. "Grey, Valsalva maneuver. Meredith was feeling a lot of pressure when he removed the tube. Meredith held her breath, at least she tried, she couldn't focus than anything besides her inability to breathe, tears were blurring her vision. She felt Derek stroking her cheek and talking soothingly to her. Burke disposed the first one and then he followed the same protocol as with the one before that. This time Meredith was more prepared for this kind of pain. This was uncomfortable but nothing against the removal of the third tube that goes into her pericardium. That'll hurt a hell lot more. Immediately after the tube is removed, he applied an occlusive dressing over the site to ensure that the area is airtight and he secured the dressing with occlusive tape. Then he looked up, preparing to remove the third chest tube as well. "Okay, Grey. The first two tubes are out, the third is to follow. But this one goes into your pericardium so you are going to feel more discomfort than when removing the ones before. You're doing great." Burke told his patient. Meredith turned her head to Derek who runs his hand over her hair, supporting her. He knew this was going to harsh and painful, a devastating pain. "Let's get started." Meredith had barely time to prepare herself for what was happening to her. A searing, almost unbearable pain shot through her chest, it was a lot worse than the times before this. Meredith squeezed her eyes shut, clung onto Derek's hand as if it were a life vest. She gasped, she will naturally exhale, which will also prevent air from entering the tube's tract. She was suddenly feeling the sensation of bile rising up in her throat as Burke already removed the tube.

Everything seemed to go fuzzy. She barely got out: "Bucket." Cristina reacted first, grabbing the bowl that was standing nearby, Derek was holding her hair back and Burke was putting pressure on her sternum to cushion the incision so that she isn't putting any strain on it while she emptied the contents of her stomach into the bowl.

When Meredith's vomiting streak ended, Derek helped her lay down into the covers again. She seemed exhausted and tired out from what just happened. Her eyes were glassy and Derek was frantic.

"Why did this happen?" He asked, being once again overprotective of Meredith.

Cristina looked at the heart monitor for any changes but so far, everything was okay. Burke laid a calming hand on the neurosurgeon's shoulder: "It happens sometimes, Derek. She is a okay as she can be right now. It's all coming back to one now, the stress, the pain and the meds – I am surprised that this hasn't happened earlier." Derek grasped Meredith's hand. "But I want you check for infections, she already had one which puts her at risk for relapsing. Are you sure it's not an infection?" He was nearly hysteric.

"It's happens." Cristina interjected, repeated what Burke said.

Derek nodded, he was looking at Meredith's face. He all too well remembered her pained expression after they removed the third tube. Meredith opened her eyes when she felt a light pressure on her hand. She tried to smile but the oxygen mask that was covering mouth and nose made it difficult. Dr. Burke stayed to continue to assess respiratory status to make sure there's no recurrence of a pneumothorax or accumulation of fluid—a risk if the tube was removed prematurely or air was accidentally introduced into the pleural space during removal. But so far everything was just fine.

"She should be feeling much better soon and more comfortable since the tubes are out, man. Just give her time to rest." Burke advised. "But I still want to do another chest X-ray to make sure the lung is still expanded." He was monitoring the oxygen saturation with pulse oximetry, and he told Cristina that she should report any decrease in SpO2, increase in the work of breathing, diminished breath sounds on the affected side, or increased restlessness or chest discomfort. Also, she should observe the dressing for persistent bleeding, which may indicate that the tube was lying against a vein or artery of the chest wall before removal. Cristina nodded. That she can do. At least she won't feel so helpless.

* * *

Addison was in an exam room with Thatcher Grey to discuss the proceeding of the of the paternity test. He was nervous and when Addison told him how this whole thing works, he interrupted her: "Maybe this isn't a good thing that we are doing. I mean, even if I am ... if the result's coming back positive, where does it get us?" He sighed. "Lexie won't even talk to me anymore after she confronted me about this. What if it's a mistake?" He was desperately looking for answers. "Did you know Ellis was carrying your child, your sick child?" The question hung in the air. Thatcher Grey shifted uncomfortably.

"I knew about the pregnancy, yes but does it change anything? No." He exclaimed.

"Maybe. It does change something. You have two other children, Lexie and Molly. I've been treating Molly for months now. And don't you think that they deserve to get to know their older sister? They seem decent raised and when I'd be in their position I would want to know." Addison replied. "I would want to know if I had another sister." Thatcher didn't budge, he just continued to stare at the ground.

"I know her." She suddenly said.

"Who?" Thatcher asked back.

"What do you mean, who?" Addison asked back bitterly. She liked Meredith. There was a time where she wanted to be angry her for stealing Derek's heart but soon she found that Meredith was an easy person to like. She is sweet and lovable. And she sees that Derek really loves her. Meredith Grey is not an easy person to hate. And Addison does **not** hate her.

"Who is she?"

"She's an intern here." She told him. "She hasn't had it easy in her life. That's all I can say to you. Maybe, if the results come back positive, you could try and arrange a meeting with her. To get to to each other." Thatcher didn't answer. Without saying anything, he let Addison continue the procedure. "So we are finished." "That was pretty quick." Thatcher said. "Am I free to go? Will you inform me when you get the results?"

Addison just nodded and Thatcher left the exam room.

But he didn't expect his daughter waiting for him as soon as he exited the exam room. "Dad." She said. Her eyes were looking at him. Something was awkward about this situation. "Lexie." He greeted his daughter. "What a nice surprise." "Well, apparently I am not the only surprise." Lexie mumbled bitterly. "When were you planning on telling us about this other daughter?" Intensively, Lexie stared at her father.

He flinched.

"I can explain." He stuttered, knowing about what that was about. "Then do so. You have one hell of explaining to do. To me, to Mol. And at last, to Mom." Lexie gritted her teeth. "Lexie." He called out.

"What, Dad? Why haven't you told us?" Lexie demanded to know. She wanted the facts. All the facts, even the ugly ones. "Because I left her mother before she was born. I didn't stayed long enough to see her after her birth. And now you hate me too, and I probably deserve it." He said. "How could you leave your own flesh and blood?" Lexie exclaimed. "If you hadn't run, I might have grown up with an older sister. You running took that from me."

Silence. Both adults were standing there, not talking.

"I was married before I met Susan. Her name was Ellis Grey. We didn't work out, she had an affair, got pregnant and then I left." "She got pregnant while she was having the affair?" Lexie asked, maybe this child wasn't even biological his child. "No, that was before." Thatcher said, "But we didn't work out and I ran. She was almost eight months along, in her third trimester." He said. "But I didn't stay long enough."

"Yeah, we've established that now." Lexie snapped at her father.

"Does Mum know? Because I told Molly but I bet she wants to hear it from you to."

* * *

Meredith was being transferred to another room after they did a repeated CT to make sure that the antibiotics work and one for one are killing all the bacteria. She'd told Bailey that they didn't need to do that, that she was fine but Bailey didn't listen to her. But she was happy about the transfer She was relieved about that. Now most of the catheters were gone, also the foley bag for the urine. Now she is able to move more freely around, okay, she was still connected to the cardiac monitor and the pulse oxymeter still held her middle finger hostage and there were still two drains in her chest because she was still losing fluids and Burke says it's too soon to remove them and that he wouldn't want to risk it.

But these drainages were pretty uncomfortable, because of them she couldn't move that much. She wasn't alone. Bailey seemed to wait for someone. She kept looking to the floor, Meredith pressed the button to move the head part of the bed up, so that she could sit.

"What are you waiting for?" She asked her superior with curiosity.

"Wait." Bailey replied, without even looking at her.

"Why are you so cryptical, Bailey. What won't you tell me?" Meredith was getting on the general surgeon's nerves.

"Grey. Did I say anything about driving me crazy with your questions just because you can't wait." Bailey shut her up. But it didn't last very long. "Are you talking like that to all your patients or just the ones that are your interns, like me, who, by the way in case you forgot, had open heart procedure recently or Cristina when she had the whole ectopic pregnancy thing going on?" Bailey glared at her. "Try to stay patient." She said.

Meredith stayed patient, but after a few seconds she asked again: "What, or better who, are you waiting for." But before Bailey could answer, another woman stomped into the room. "What's going on. Did he changed his mind?" Bailey asked Addison silently. Non-verbally, Addison shook her head. "No, he didn't. It's just, men are egoistical, that's all. Can't you just drop it, so I can talk to Meredith?" Bailey nodded.

Meredith recognized Addison. Oh, was she pregnant? She couldn't carry child, that could kill her in her state ... she couldn't. But nobody seemed to see to oncoming panic in Meredith's face.

"Am ... am I pregnant?" She asked, her voice shaking uncontrollably.

"Is that why you are here?" Meredith continued.

When Addison and Bailey heard the young doctor questioning them if she was pregnant, they stopped talked and turned to her. "Am I?" Meredith wanted to know. "What aren't you telling me?" She looked at the two surgeons. Miranda Bailey was the first to speak: "No, Grey, you are not." She told her. Meredith closed her eyes for a moment and let the news sink in. She wasn't pregnant. She was relieved, at least she was supposed to feel that. But there was another feeling she wasn't sure what it was. But before she could figure out what it was, Addison started talking: "You remember Molly Grey, the patient?" Her question hung in the the room. Bailey and Addison waited for an answer.

Meredith nodded. She remembered Molly Grey. She was the intern on her daughter's case. "I remember her, I was the intern on her daughter's case before I was called to the chief's office and I somehow ended up being cut open and lying in stepdown unit." Meredith answered, the last part sounded cynical.

"Grey. Thatcher Grey agreed to do a paternity test." Bailey stated the facts. Meredith's face expression didn't change. "You need to take some blood, don't you?" Meredith answered. "Alright, this blood- thing isn't neccesary, I know. How soon can we start?" She asked, quickly correcting her mistake. "And we need you to sign this." Dr. Bailey passed her a formal piece of paper along with a ballpoint pen. It was a consent form for the test. The logo of Seattle Grace Hospital was the first thing she noticed. "Okay." Meredith murmured to herself, clicked the pen a few times before she actually wrote her signature where they needed her to sign. "Then let's get this show on the road." She said. "I'll get the supplies." Addison left the room.

When she was back, she brought a set of Buccal swabs to collect Buccal cells found on the inside of a person's cheek in order to do the swabs have wooden or plastic stick handles with a cotton on synthetic tip. The collector rubs the inside of a person's cheek in order to collect as many Buccal cells as possible. "Okay, shall we start?" Meredith opened her mouth and let Addison perform the test. Soon, they were done. It only took a few seconds to take the samples. "So, now we just need to sent the Buccal cells to the laboratory for testing. I've already taken the samples from Thatcher Grey, so now we can sent them to the lab to complete the paternity testing." Meredith nodded.

* * *

_Post- operative Day sixteen: _Meredith Grey, who was currently lying to stepdown unit due to previous open heart procedure with pacemaker implantation and recovering from post- operative complications. But since she had been presented as stable for the last few days and her chest tubes have been removed, her doctors decided it was time to get her up and mobilized. She had been sitting up but not walking. She should try with walking a few steps. Meredith slept. Derek watched her doing it. On a table were lying some medical books. When he asked her why she told him that she already started studying for the big intern exam that was coming up.

Derek was with her when Bailey, Burke, Cristina and a physical therapist entered her room in stepdown unit.

"So, it's time, Grey." Bailey said when she entered the room followed by the others. Meredith didn't even stir when she heard the voices. Derek immediately knew for what they were here.

"Wake her." Bailey said when she saw Meredith's soundly sleeping frame in the bed.

"You want to start with ..." He didn't had to complete the sentence. Bailey nodded. "Wake that girlfriend of yours so that we can get her back on her feet. It's been a long time and we really need to get her up and walking. She has to train her muscles." "I know." Derek replied and softly whispered her name: "Meredith, wake up." When she didn't budge, he tried again: "Mer." He said, but nothing changed but her breathing.

But still, she didn't wake up. Derek sat down on the edge of her bed and softly stroked her cheek, then he kissed her on her forehead and whispered: "Mer, it's me, Derek. I need you to open your eyes." Meredith's eyes fluttered a bit and then her gaze focused on Derek's figure sitting there, smiling.

"'s a nice way to wake up." She mumbled in the cushions, still unaware what she was about to do. "Good." He kissed her for a second time, this time on her lips. Then she noticed the other people, doctors in the room, watching her and Derek. Burke took a step forwards and asked her how she was feeling. "Tired but okay." "So, are you ready to get out of bed?" He asked. Meredith's eyes lit up when she heard that. Finally. The chest tubes were gone since yesterday, they weren't needed anymore which meant now was the right time to get up and start walking.

"I am more ready than you think I am." She answered. "That's good. Shall we start?" Derek smiled but this smile disappeared when he saw Meredith adjusting to the bed being so upright. It had never been that upright before. It was hard for her, he could see that but she seemed determined to do this. In the meantime, Burke unhooked everything that could be unhooked. Burke hung the infusion bags on a rolling pole. "Are you ready?" Derek asked her, seeing her struggle. Meredith closed her eyes for a milisecond before she opened them again. "Are you sure ... because if you are not ..."

"I'm ready." She cut him off.

"I just ... need a second." Derek just squeezed her hand for support as reply. They sat there in silence before Meredith was ready to try. A minute passed, then another. "Okay, then. Are you ready, Meredith?" Burke asked. Meredith nodded. "Okay, you know the drill. Swing your legs over the side of the bed." He instructed and Meredith did as he says. Her expression looked pained but she didn't made a sound.

Derek felt tears in his eyes when he saw Meredith struggle with a motion that's supposed to be simple. But right now, after open heart surgery recently, it wasn't easy. He couldn't do anything, she has to do it herself, needed to be able to do it herself. Derek knew by the look in her eyes that it hurt, that she was in pain. But somehow she got through it, and now Meredith was sitting there on the side of the bed, unsupported.

She wheezed in pain as she searched for someone to hold onto. Derek was there, helping her. He was unable to just stand there and watch her being in pain. Thankful for him being there, she acknowledged his presence. He kept rubbing back to relax her and somehow, it actually worked. She smiled at him for a second and when he gave her the heart- shaped pillow she immediately held onto it, the soft pillow made her chest ache less.

For a moment, Meredith closed her eyes.

Silently wishing that she was someplace else. On a beach maybe, with Derek. Anywhere but here. Without all of this. Without struggling to do simple motions like sitting up. She didn't realize it would that hard. She had been feeling relatively good, partially even stronger than before the surgery but now? Now she wished she hadn't had this surgery. Without it, her chest wouldn't hurt that much. But since there is no way that she change these things it's the best just to go with it.

"Meredith." A gentle voice pulled her back to the harsh reality.

"Are you okay? Do you need me to get ..." Meredith bit onto her lower lip and shook her head. "No." She responded. Her fingers were gripping around the rolling pole, tightly. Her knuckles were almost white. "It just ... takes a while to ..." She drew in a deep breath. "... to adjust."

"It's hard, I know and it's gonna take time and strength. That's the hard part. When you feel up to it, lean forward and grip the IV pole and stand." Bailey told her intern.

Meredith shifted, slowly leaning fowards and her feet touched the ground- and she finally standing up.

Bailey offered her a supporting smile but Meredith was too preoccupied to hold her balance that she didn't notice. She panted loudly, trying to catch her breath and she took a small, unsteady step. It was easily nothing but it was. It was something. She was shaking slightly. Cristina and Derek both stayed silent, they knew Meredith wasn't hearing the words of encouragement the physical therapist was spouting off.

"How does that feel?" Her heart surgeon asked Meredith, he was keeping a close eye on Meredith's balance.

"Oh." Her neck straightened, she even looked over to Derek, a small smile covering her lips. "You're standing, Mer." He said, encouraging her. "Feels like I weigh a thousand pounds ..." She answered. "That'll fade. You're up and standing which is the hard part. You are doing great, Grey. Do you want to take couple of steps or do want to sit?"

"Couple ... steps." Meredith answered.

After she took a couple of steps, the pillow pressed against her fractured sternum to support it, of course it still hurt, no question, but it relieved the pain a bit. In the middle of the room, Meredith suddenly felt light- headed. This wasn't good. Maybe she should sit. Burke noticed it too. "Grey, are you okay? Do you need to sit?" Then the others in the room noticed it too. "Mer?" Cristina asked. Fear was in her voice.

"Grey. You need to sit down." Burke ordered, he was trying to get her to listen but for such a tiny person she was really stubborn. "Grey. Stop. If you push yourself too hard, you'll delay your recovery."

Derek was on her side, within seconds, his hands were stabilizing her hips. "It's okay, Mer. You're safe. I've got you." He murmured softly. "You did great. But maybe overdoing things isn't a smart choice right now, okay."

Meredith didn't respond.

* * *

**A/N: How did you like it? I was able to post this chapter faster than anticipated. There wasn't very much Thatcher / Meredith interaction but that's coming somewhere in the following chapters. Also, Lexie and Meredith will meet. You may have wondered what this flashback was about. It's going to be another storyline and it's mostly about the twisted sisters ... The next chapter will contain a flashback from Cristina's point of view when she was nine. But no worries, there will be more than enough MerDer scenes coming along with it. And, don't worry, Mer's going to be okay ... Please, review. I am a big fan of reviews ...**


	23. Chapter 23

**Chapter 23**

* * *

**Uncontrollable bleeding. Acidosis. Cold. We all know what the combination means. We call it the triad of death. The point of no return. It's the moment in the OR where you turn to damage control. You stop. You step back. You let the body rest and see if you find a solution to the chaos that's , we have to go back. Take another look. We have to ask ourselves: can this body be put back together? If w****happening inside. Once the chaos subsides w****e've done our jobs right, it can. We stop the bleeding. We sew up the damage. We make the body whole again. But no matter how hard we try, we have to realize some things just can't be fixed. **Bend And Break; Arizona Robbins and Callie Torres

* * *

_Post- operative Day sixteen: _"I am more ready than you think I am." She answered. She hated being confined to a hospital bed. She had been in this situation more than she could count and every time, she hated it. She hated being a patient, she didn't like being that stationary. "That's good. Shall we start?" Derek smiled but this smile disappeared when he saw Meredith adjusting to the bed being so upright. She took a hissing gasp of air. It was hard and it was a painful struggle but she needed to do this. It was an important step in her recovery. It had never been that upright before. It was hard for her, he could see that but she seemed determined to do this. In the meantime, Burke unhooked everything that could be unhooked. Burke hung the infusion bags on a rolling pole. "Are you ready?" Derek asked her, seeing her struggle. Meredith closed her eyes for a milisecond before she opened them again. "Are you sure ... because if you are not ..." Derek asked her worriedly, he just wanted what was best for her. He would hover, worry as long as it meant that Meredith would be okay. She would have to deal with him hovering, even if she didn't like it. Bailey and Burke were standing there, looking at the progress Meredith made ... Now ... And in the last few days ...

"I'm ready." She cut him off. "I just ... need a second." Derek just squeezed her hand for support as reply. They sat there in silence before Meredith was ready to try. A minute passed, then another. "Okay, then. Are you ready, Meredith?" Burke asked. Meredith nodded. "Okay, you know the drill. Swing your legs over the side of the bed." He instructed and Meredith did as he says. Her expression looked pained but she didn't made a sound. Derek felt tears in his eyes when he saw Meredith struggle with a motion that's supposed to be simple. But right now, after open heart surgery recently, it wasn't easy. It was n't anywhere near easy for her ... He couldn't do anything, she has to do it herself, needed to be able to do it herself. Derek knew by the look in her eyes that it hurt, that she was in pain. But somehow she got through it, and now Meredith was sitting there on the side of the bed, unsupported.

She wheezed in pain as she searched for someone to hold onto. Derek was there, helping her. He was unable to just stand there and watch her being in pain. Thankful for him being there, she acknowledged his presence. He kept rubbing her back to relax her and somehow, it actually worked. She smiled at him for a second and when he gave her the heart- shaped pillow she immediately held onto it, the soft pillow made her chest ache less. For a moment, Meredith closed her eyes. Silently wishing that she was someplace else. On a beach maybe, with Derek. Anywhere but here. Without all of this. Without struggling to do simple motions like sitting up. She didn't realize it would that hard. She had been feeling relatively good, partially even stronger than before the surgery but now? Now she wished she hadn't had this surgery. Without it, her chest wouldn't hurt that much. But since there is no way that she change these things it's the best just to go with it. And make the best out of the situation.

"Meredith." A gentle voice pulled her back to the harsh reality. "Are you okay? Do you need me to get ..." Meredith bit onto her lower lip and shook her head. "No." She responded. Her fingers were gripping around the rolling pole, tightly. Her knuckles were almost white. "It just ... takes a while to ..." She drew in a deep breath. "... to adjust."

"It's hard, I know and it's gonna take time and strength. That's the hard part. When you feel up to it, lean forward and grip the IV pole and stand." Bailey told her intern.

Meredith shifted, slowly leaning fowards and her feet touched the ground- and she finally standing up. Bailey offered her a supporting smile but Meredith was too preoccupied to hold her balance that she didn't notice. She panted loudly, trying to catch her breath and she took a small, unsteady step. It was easily nothing but it was. It was something. She was shaking slightly. Cristina and Derek both stayed silent, they knew Meredith wasn't hearing the words of encouragement the physical therapist was spouting off.

"How does that feel?" Her heart surgeon asked Meredith, he was keeping a close eye on Meredith's balance. "Oh." Her neck straightened, she even looked over to Derek, a small smile covering her lips. "You're standing, Mer." He said, encouraging her. "Feels like I weigh a thousand pounds ..." She answered. "That'll fade. You're up and standing which is the hard part. You are doing great, Grey. Do you want to take couple of steps or do want to sit?" "Couple ... steps." Meredith answered. After she took a couple of steps, the pillow pressed against her fractured sternum to support it, of course it still hurt, no question, but it relieved the pain a bit. In the middle of the room, Meredith suddenly felt light- headed. Many little black dots were dancing before her eyes and only bleary she could make out the people in her room. She pinched her eyes, trying to make this feeling disappear but for the most part she hadn't been very successful.

This wasn't good. Maybe she should sit. Burke noticed it too. "Grey, are you okay? Do you need to sit?" Then the others in the room noticed it too. "Mer?" Cristina asked. Fear was in her voice. "Grey. You need to sit down." Burke ordered, he was trying to get her to listen but for such a tiny person she was really stubborn. "Grey. Stop. If you push yourself too hard, you'll delay your recovery." Derek was on her side, within seconds, and his hands were stabilizing her hips. "It's okay, Mer. You're safe. I've got you." He murmured softly. "You did great. But maybe overdoing things isn't a smart choice right now, okay." But I wanted to make it to the door, a childish voice in her head whispered. But in her rational mind she knew there was no way she was making it to the door. She would collapse before. That much was clear.

Meredith didn't respond. There was one thing she could do. That was to keep breathing. And maybe steadying her balance, which was almost impossible if Derek wasn't here. Without him, she would have been on the ground a long time ago. But his warm hands were stabilizing her, making sure that she doesn't fall. She feels him breathing behind her, every second a small gush of air met her neck and it calmed her. She was focused on keeping her balance. But it was just so damn hard. When did become walking that freaking hard? Faintly, she could hear the others calling her name, telling her to sit down before she's falling. Everything was fuzzy. Her legs were wobbly and she was feeling weird. Then, luckily, there was this visitors chair standing in the corner. Without knowing how she got there or where she got the last resources of her strength, she sat down. She was relieved because she wasn't sure if her legs were able to hold her any longer. She wasn't really sitting down on it, the more she plumped on it.

Derek was with her, murmuring words of encouragement and holding her. A wave of love swelled in his chest. She leaned her head against his shoulder. It was perfectly quiet in the room. Everyone's eyes were watching here attentively as if they feared that she would lose consciousness at any moment. The room was still blurry and moving around her. But slowly, it got better. Meredith breathed deep in, trying to make the dizziness disappear. She closed her eyes, she tried to gather all the strength she had left and prepare for what was coming and what she needs to endure.

Meredith was just sitting there, head against Derek's shoulder. Minutes and seconds passed. Only slowly, Meredith recuperated from this strain. Her breath rate got more regular and her muscles began to relax more. The pain also did subside a little bit. Burke didn't like this situation. Meredith, more lying than sitting in this chair, her eyes were half- closed. "Okay. Grey." He said, loud enough for Meredith to hear. Meredith blinked as she recognized Burke's voice. She could hear him talking to the others in this room, could vaguely make out what they are saying. He grabbed her arm and felt for her pulse. Derek watched every step of what Burke is doing. He wanted to know how Meredith was doing.

"Her pulse is regular but a bit thready, so I suppose that she tries to go back to bed to lie and repose. Maybe, in a few hours or in the evening she's ready to try again." Dr. Burke discussed with Cristina and Dr. Bailey. "Sounds reasonable." Bailey agreed, Cristina just nodded. Her eyes were focused on her person. Meredith blinked as she heard Dr. Burke saying these words. Even if she only heard him vaguely. "What if I ... try now? I ..." She breathed in. "I can make it to the door." She took two gasps. Her eyes were halfway open. Dr. Burke cleared his throat. "I am sure you can but still, in the quite the contrary we won't do it because there is the risk of delaying your recovery if something happens now. It'll just set you further back and you will have a longer way to go." He told her. Bailey and Cristina seemed to side with Burke, just to be on the safe side. "I suppose you go lie down and we can see and reassess and maybe try in the evening." He then told Derek who wanted to know what was going on with Meredith. "Okay, how do we proceed ... from here?" He then asked, motioned towards Meredith.

"Or we can try now." Meredith's voice was barely audible. All doctors in the room turned to her. They couldn't make sense of what she said. They all knew it wouldn't be a good idea. "Meredith." Derek took matters in his own hands. "You need to rest. You can barely keep your eyes open." He tried to convince her to do the right thing. "But I want to." She whined. "You already surpassed it. The goal, I mean. You ..." "He's right." Cristina supported Derek. Meredith looked like she considered protesting a second time but Derek gently shushed her: "But you can't right now. Come on, we'll try again in a few hours. 'k? Until then, you're resting." "Are you prescribing me that?" Meredith asked boldly, she then giggled slightly. On Derek's lips a smile formed when he saw Meredith was returning to her old self. "If you want me to, then my answer's yes." He replied and kissed her. "We don't want to interrupt you but you know that you're still sitting in that chair, Meredith. How do you want to get back to bed if you are supposed to be resting." Cristina's word cut through the silence.

Meredith slowly stood up, steadying herself before she took three steps to the bed. Only supported by the rolling pole. The rest she did herself, Derek close by. She tuned everything else out, after a few steps she had to stop. After what seemed like an eternity, she made it to the bed. She shuffled, each breath came out as a slight gasp. She kind of was relieved when she was sitting on the edge of the bed. "Do you need to lie down?" Meredith shook her head. "I am fine." She insisted. "Sitting up isn't really bad right now." "That's good sitting up is good for you. Come, we give them their privacy." Dr. Burke said and led the others out of their room.

"Are you really fine?" Derek asked her.

Meredith was still breathing heavily. "I am okay, Derek. I didn't lie when I said that sitting up isn't really bad right now. It's good for me, you heard Dr. Burke. And I want to get well sooner rather than later because I miss lying in one bed with, I miss our activities ... you know what I mean." Meredith motioned Derek to sit down next to her and just hold her. "I know. I miss that too but I know that we will do them when you're free and cleared for any activity. Then we'll have the best sex you've ever had." Derek smiled and embraced her with his arm. "I am not hurting you, am I?" He asked worriedly. Meredith shook her head. "Even if you would, I would want to be lying in your arms." With that, she snuggles deeper into Derek's warm embrace, feeling his hands on her back. "You could never hurt me, Derek, I love you." Meredith whispered.

* * *

_Post- operative Day seventeen: _"Cristina." Burke called after the young soon to be surgeon. Cristina stopped walking away from the heart surgeon and turned around. Her eyes were fixating on Dr. Burke. Who seemed to be wanting something, something specific. "I have a case for you. Do you want it? It's your time to prove me that you're up to the challenge." He then told her. After short thinking about it, Cristina knew what she would answer. Hello? It was a cardio case. Everything that has to do with cardiology means, she is in. "I am." Cristina replied, immediately lightening up once he mentioned a cardio case. "That is good. It didn't surprise, though. You are always eager for surgeries, but don't except a surgery. Maybe there won't be a surgery." He warned her. Cristina frowned. No surgery? Exactly, he said maybe there won't be a surgery to scrub in on. "Okay, fine." She said.

"I'll do it. Do you know how Mer's doing? Is she trying to walk?" She asked. "Well, I did check on her and I had seen her and Shepherd doing the walking thing. I made him promise to page me if something happens. But he's a fully trained doctor and I am sure he knows Grey's limits." Cristina looked at him and then answered, pointing out the obvious: "But he is also a family member in there. But I should probably get going." "You are right, your patient is waiting." With that Burke handed her a small patient file. Cristina took the file and opened it to get a quick overview over the situation.

Cristina was elated but when Burke told her to be nice to the family, she just rolled her eyes and replied: "I am always nice." "Nah, I am not so sure about that." He answered and laughed a bit. Cristina looked at him and without another word she disappeared. Her patient and the family waited in an exam for a doctor.

A hysterical family including father, mother and older sister waited impatiently for their consult - which was, like you already assume, Cristina Yang. Who was quite shocked when she saw all these people who immediately started firing questions at her when she entered the exam room.

"Are you ..." The mother asked helplessly. The older daughter didn't even understand what was going on.

"They told us you ..." The father began to speak but was interrupted by his wife: "Are you the doctor, I hope you are the best because we need the very best and ..." "Dr. Burke already told us, Dr. Yang is a very talented and competent doctor, she'll do this. I am sure." He calmed his wife down. Cristina used to the silence to introduce herself.

"I am Dr. Cristina Yang and I'll be performing the exam today." She shook hands with both parents. The father said: "They sent us here because the doctors noticed a abnormal heart sound when we were there for the early detection examination with him. They sent us here for further diagnostics. Cristina nodded and then started with some standard questions about if they had prenatal diagnostics and if there were any chromosomal aberrations, if a genetic defect was detected like trisomy 21, trisomy 13 or trisomy 18 ... But the parents answered every single question with a no.

There weren't any chromosomal defects or anything. The pregnancy went uneventful and their baby had been born on the end of their third trimester, around 39 or 40 weeks. "Then I have to ask you ..." She adressed the mother who held her baby's hands. "If you have taken any drugs or medication during pregnancy?" Cristina looked at the parents, expecting an honest answer. The mother faltered, not knowing if she should say something. "Did you or did you not?" Cristina asked again, sensing that there was something off. Silence- "Okay." Cristina sighed loudly.

"It would be very helpful if you just told me if you have taken anything, medication prescribed or not, drugs or anything that is in any way embryotoxic." "What does embryotoxicity mean?" The mother asked back and shifted uncomfortably. "Embryotoxicity or it's also called teratogenicity means that a drug or medication is dangerous to the baby. It can affect its development, the structure or functioning of organs." Cristina explained, hoped that she would answer her question. "No I haven't taken anything. I just wanted to ..." She didn't complete it.

"Okay. Now, does anybody of you have a history of unexplained deaths in the family or do you have a history of diabetes mellitus?" She asked further questions. Then she was ready to perform the echocardiography.

"Now I am going to have a look at his heart." She told them after she listened to his heart and noticed a murmur that sounded like a ventricular septal defect. But they will only know for sure if they do the ultrasound. After she finished with the echocardiography and the electrocardiogram, she prepared to tell them the diagnosis.

Cristina just finished an echocardiography on a five month old baby and told the shocked parents that their child had a cardiac defect. "When I did the echocardiography I could discover that your baby has a hole between the left and the right ventricle. This is a fairly common heart defect known as ventricular septal defect. In this case, blood flows from the left ventricle into the right ventricle and this is the so-called left to right- shunt, a connection between the ventricles." She didn't sugarcoat them, she just ripped off the band- aid and went from there. Stating the facts.

They were both shocked. As soon as they've recovered from it they started asking questions. Mostly the mother. "What, wait." She mother said in tears. "So there is a hole in his heart? What are the consequences of that? Will he survive?" She asked one question after another. "Irina, stop and take a deep breath." Her husband advised her. "She can't answer your questions if you don't let her." He told her. She nodded, a sign that she understands what he means.

"I am ..." The mother cleared her throat. "Don't be. It's okay to freak out. A lot parents do when they hear their kid is sick." Cristina explained.

"So, let's start again. I am going over this again with you, to explain eventual unclarities that will come with." The parents nodded. "Yes, little man, let's begin. No, no, don't touch it, ok?" She said in another voice when they baby grabbed her stethoscope that was still hanging around from her neck. "It's stethoscope. With it, I can hear your heart ... oh. It will hurt you." She said. The baby cooed and looked at her with his blue eyes. "I am sorry." She apologized to the parents. "It's okay. But now, what are we gonna do?" The father asked. By the sound of his voice you could see that he was helpless and had no idea what to do. "We wait and see." Cristina answered. "This defect is the most common heart defect. It's easy to correct but in most cases ..." But before she could finish her sentence, she was interrupted.

* * *

Addison was in an exam room with Thatcher Grey to discuss the test results of the paternity test. "Okay, here I have the results of the paternity test." She began. Thatcher just looked at her, waiting for her to continue. "Does she already know?" He then asked, his voice hoarse. He remembered when he had told Molly and his wife Susan about this. They weren't really pleased when they heard about this. Susan acted relatively understandigly but Molly, she had been quite angry when he told her about her maybe half- sister. But now ... The results came back. They came back positive. He was the father of Meredith Grey, who was currently lying to stepdown unit due to previous open heart procedure with pacemaker implantation and recovering from post- operative complications. "No, she doesn't. We will tell her when I am finished here." She said. Thatcher nodded. "What will happen now?" He asked.

"What am I gonna do? I feel like everything's crumbling around me ..."

"That's yours to figure out. Maybe you should think of something you want to say when you're both ready to meet. 'Cause she'll have questions and it's your job to answer them." He shook his head. "It's not. I may be her father biogically, genetically but I am not her dad." He answered. "I have two girls and lovely wife. I am happy in my life." He said, staring at the wall. "You have three girls, Mr Grey." Addison told him, anger flooded through her veins, why doesn't he care that he has another daughter that's biologically his? Why? But she was able to keep it down.

"So you don't want to meet her?" She wanted to know, just in case Meredith's asking. He shrugged. "I don't know. It seems wrong. Suddenly having someone telling you that this person's your father- I don't know. Maybe." Addison breathed in. "Do you at least want to know her name?" She asked.

"What's her name?" He asked back.

"Meredith Grey." Addison simply answered.

* * *

"Does he need heart surgery? That sounds terrific-" The anxious mother asked and stroked genty the hand ofher little boy. The parents looked at Cristina expectantly. Waiting for her answer. "In most cases, surgical repair isn't always neccessary. In his case, it's not. We just wait and see how he reacts. If he starts deteriorating we will consider surgical VSD closure but for now it is medically not neccessary. His hole between the chambers is pretty small and it's located in the muscular septum. It is quite possible that it closes in the next few years itself. Nevertheless, it must be observed regularly." Cristina told them.

"Regularly. And with observing you mean check- ups or ..." Cristina nodded. "Yes, you have to come every six months for check- ups, the doctor does an echocardiography, pulse oxymetry and electrocardiogram and this will us if the VSD has closed itself or if there are any other problems with it. So there is no need for treatment. We know there is something and we'll do something if we have to. But in sixty percent of the cases the holes closes on its own. You don't have to worry." Cristina reassured them.

"Where can this be done?" The mother was quite worried and nervous. No wonder, with such a diagnosis. Although it would have been quite possible that it could have been worse to come. But for the parents is probably always the cardiac defect of their own child the worst possible defect, it just ... psycholgy.

"A specialist for pediatric cardiology does that kind of exam. A pediatric cardiologist is a doctor, especially for kids and sometimes, when he/she's ACHD certified, even for adults with congenital organic heart defects."

"Where can I find a good doctor, like a pediatric ... what was it, cardiologist?"

"A special cardiologist for children. There let resound her heart every three years and the doctor can see how far and whether the hole is closed."

"Okay." The nervous looking mother replied. "You can pick up again the child now." Said Cristina, after she had wiped the gel off of the baby's small chest. Then she said goodbye to the parents of her patient and left the room.

Now she had to find Burke, he was doing a valve reconstruction. He let her scrub in after she stated all the facts. "Good job." He told her. "Scrub in, I need some hands." Smiling, Cristina Yang made his way to the operating room. Your patient was already prepared for the table. Cristina went and entered the sterile operating room. Burke told her that she is the one who is opening up. "Scalpel." She ordered. Bokey handed her the instrument she wanted. She then did the first cut.

* * *

_Post- operative day nineteen: _They told Meredith a few days after they told Thatcher. They didn't know why, she and Bailey simply decided it was better for Meredith to concentrate on her recovery. Heart surgery isn't ... When Addison and Dr. Bailey entered Meredith's room, they walked in on Meredith who was training herself in walking with Derek on her side who supports her. "Grey." Bailey called out. "You're walking, that's good." She said. "But we have something to discuss with you." She said. Meredith immediately knew what they were talking about. The whole paternity test thing. Thatcher. Who may be her biological father. She nodded. She saw on their faces how the results are.

"They are positive, aren't they?" She asked, she looked drained. "Meredith, sit down-" Derek tried to do something. "No." She cut him off. "I don't need to, I am fine." Fine was actually the code word for not fine but right now he couldn't do anything about it. "Yes, you are right, Grey. The test results were positive." Addison told her. "Okay, give me a sec to sort this all out." She stammered, obviously overwhelmed by everything. Derek wanted nothing more than to be there for her but this time he couldn't do anything, the only thing he could do was to stand back and watch her.

"Can you get Cristina, please ..." She said. "I need her." She asked.

Her voice and her lower lip were both quivering. She couldn't believe it that she really had found her father. If only biological but it was. She didn't know what to do. Should she meet him? Or not? She would debate that with her person. "Go, get her." Bailey told Addison. "She knows what to do." Derek was helplessly trying to figure out a way to help her while he was running his hand over her back, repeatedly. "I'll go find Cristina." Addison said excusingly and quickly left the room. Meredith was Bailey's responsibility and not hers, she reminded herself. She was sure she would find Cristina in the OR. Probably in Burke's OR and she did. The OR board clearly said that Yang was in OR 4 right now with a valve reconstruction. She grabbed a surgical mask and held it over her mouth to not contaminate a sterile area.

"Yang."

Her voice was loud and clear. Immediately Cristina looked up, recognizing Dr. Addison Montgomery as the one who called her name. "Yes." She replied, waiting for her to go on. "Meredith needs you. She's requested you and Bailey and I think it's better if you come." She said.

"Is she okay?" Burke looked up from the surgical area, too.

Concern was written in his face. "But medically speaking, she's okay, right?" He asked, tension noticeable in his voice. Addison replied: "She is doing just fine, vitals are great and she's been up and walking around in her room but there is some sort of emotional thing that has gotten to her somehow."

"Okay, I am scrubbing out." Cristina said selfless and when she was finished with doing that, she immediately made her way to Meredith's hospital room. "Meredith." She called her when she entered the room. "Yang, thank good, you are here." Derek said and looked at Cristina. "She is just ... I can't do anything and it kills me. You are the one who has to figure this out. He motioned towards Meredith, who was just sitting there. Numb. Frozen. Cristina nodded knowingly and sent Bailey and Derek out of the door. Then she closed it behind them.

"Ok, Mer. Now we are alone." She said.

No reaction was coming from Meredith. She didn't budge or say anything. Meredith just sat there, with the same unseeing eyes, staring at the white painted hospital walls and listened to the monotone beeping of her heart monitor. Sadly. But Cristina kept trying, she kept positive she will get through to her. She's Cristina Yang, Meredith's person.

"He is really my father." She suddenly said. "They did this test and it came back positive."

"It came back positive." She repeated slowly, trying to figure out their meaning. "They came back positive, Cristina. All my life I never had anything like a father and now I have one."

"Does it freak you out?" She asked.

"No."

Pause.

"Yes."

Cristina didn't know what to say, she had no idea. She has never in a situation like this before. Damn it. She cursed herself. "Do you want to meet him?" She asked.

Meredith thought about it but then answered with: "I don't know. He didn't want me, he knew my mother was freaking pregnant but he left anyway." "Do you want to talk about it." Cristina asked cautiously.

Meredith shook her head. "No."

"Okay." Cristina simply replied and leaned her head against Meredith's and they just sat there. For minutes.

_Thirty minutes later:_ "Hey, Derek. I need you to get me some normal clothes from home." Meredith said. She looked at him with big puppy dog eyes even if they weren't neccessary. "Okay, I love you. I will be back in an hour. Have a nice freak out time with Cristina." He said and kissed her. Meredith replied with another kiss. "Bye, Der. Love ya too."

"So, now McDreamy's on his way home." Cristina teased her friend when Derek left the room.

"Oh, just shut up." Meredith told her.

"He'll come back soon." She had been so sure that he would be coming back in one piece ...

* * *

Derek was sitting in his car, driving back to Seattle Grace Hospital. He went back to Meredith's house to get some fresh clothes for her because she didn't want to wear that hospital gown anymore. She was tired of wearing it. So she had begged Derek to get her some of her own clothes from her home and Derek agreed. So he would have the chance to visit his trailer, to make sure everything's okay there and also he could bring some clothes for him. He was relieved when there wasn't very much traffic. But then there was this bus coming towards him, fast. Too fast. Soon it will crash into his vehicle head on. Derek's heart raced as he tried to stay calm and not panic. "Damn, why is this happening now?" He asked no one in particular, grabbing the steering wheel with both of his hands and checked if the other lane was free. Fortunaly, it was. But the bus always changed between the lanes. Clearly, the driver was drunk.

The bus came closer and closer. This damned bus. Soon the bus would hit his car head on. Derek tried to realize what was going on here, but that did not work. His brain told him to try and escape but he was like frozen, he couldn't move. The only thing he could do was secure his eyes with his hands and think of the people he loves. Meredith. Of course, she was the one to come into his mind. She was the love of his life, he couldn't leave her, no. His mother Carolyn Shepherd who would be devastated when her only son died in a car accident. His sisters. And then again, Meredith. What is she going to do without him. He tried to swerve but the bus hit him ...

Then there was a loud bang and a cry in agony escaped Derek in the same minute. Derek was thrown against the steering wheel and back again by the impact. He tried to move, but it wasn't a good idea. Crap, that hurts, he thought to himself. But he survived it. He felt a pain shooting through him, besides, he felt warm blood running across his forehead. His head hurt. That's what he realized when he could think again more clearly. He let out a gasping breath und tried to stay awake, but in the next second, Derek lost consciousness almost immediately.

* * *

**A/N: I am mean, am I not? **


	24. Chapter 24

**Chapter 24**

* * *

**We've all heard the same. It's one of those things we've learned in seventh grade science class. Adapt or die. Adapting isn't easy, though. You have to fight your competition, fend off their attacks, and sometimes, you have to kill. You do what you need to do to survive. Adapt or die. As many times as we've heard it, the lesson doesn't get easier. Problem is we're human. We want more than just to survive. We want love. We want success. We want to be the best that we can be. So we fight like hell to get those things. Anything else feels like death.** Meredith Grey; I Will Survive

* * *

He was thrown against the steering wheel when the impact hit him full force. He felt blood running over his forehead. Warm blood trickled down his cheek and dripped onto the surrounding objects. He vaguely heard the cracking and breaking of sheet metal and the cry of the passers-by. Then he lost consciousness. After some time he gained it back. Derek was confused. He feeling dazed. Where the hell was he? And why he was unable to move? And that had happened? How long has he been here? He had feeling lost. Carefully, he shifted his feet. Well, it worked. His spinal column was intact. At that moment it occurred to him. He had had a car accident. Someone's head down into it. A bus that crashed into his car head on darkly, he could recall the details of what had happened. But not everything. Many thing were still ... Then another thing that he remembers gets to him and he gasped, his eyes wide open.

Meredith was having heart surgery. He groaned suppressed. The moment he felt ran a liquid over his face. It smelled like iron, probably it was blood. His blood. He could hardly breathe, something was cutting off air, he fumbled his seltbelt, maybe that was the cause. Derek wanted to loosen it it, but it was hard for him to focus on it. Everything seemed kinda blurry. Pounding pain was hammering in his head, he had to pull himself together. Do it for Meredith, he told himself, and then finally it clicked ... He was free. At least he could breathe again. That was a relief for him. For a moment he closed his eyes, but he knew as a neurosurgeon, it was better if he tried now to stay awake and alert . But he was sure that he had suffered a concussion, that much was clear. At least a mild or a moderate one. He was sure of that. In addition to the headache and he was doing relatively well. Meredith was what the one thing that kept him going, she was the one thing keeps him from just giving up. The phone, it was still in his pocket. Blindly, Derek fumbled for his cell phone. In vain. He was unable to grasp it. Once again he lost halfway consciousness. Points danced before his eyes.

Suddenly he heard a voice speaking to him. Maybe a paramedic or someone.

Some passers-by who witnessed the accident, immediately alerted emergency services. When they arrived with several ambulances, offered them a picture of horrors: A bus is slammed against a car, head on. Derek tried to open the door. He wanted to get out of that vehicle which was almost totaled. He breathed heavily, trying to regain control about his motor functions. "Hello? Are you okay?" Someone asked. "Yes." He slurred, his voice sounded different. He tried to keep his eyes open. "I am fine." He then said almost inaudibly. "Sir, we need to get you out of there." He meant the wreck, didn't he? The man opened the door of the car, then he stuck his head through the now opened door. "Are you okay. Are you hurt?" Derek shook his head. "Just ... head." He mumbled sleepily. "Hey, you stay awake." The man urged him. Whoever this was, he had a certain level of medical knowledge. "Won' hurt me. I am fine." Derek replied. "Sir, I don't think you are. You need medical help." The man had quickly assessed the situation. After the man had helped him out of the car, he sat down. The world around him was moving but he told him to stay responsive. Some other paramedics were helping the bus driver and the other passengers. He had been injured in the crash but Derek didn't care. He was the one who rammed his car.

He had just been on his way back to the hospital, nothing more. It wasn't fair. Why did this happen? But it could have come worse. Him seriously injured. But now, he was pretty sure that it was just a concussion and the gash on his forehead that needs to be stitched up. He didn't need an ambulance. He was fine.

* * *

Meredith was in her room in stepdown unit, lying on her bed. With her was Cristina. "So, now McDreamy's on his way home." Cristina teased her friend when Derek left the room. "Oh, just shut up." Meredith told her. "He'll come back soon." She had been so sure that he would be coming back in one piece ... "Are you really okay with this?" Cristina suddenly asked. "Okay with what?" Meredith asked back. "With the whole long lost father thing. Are you really okay with it?" She repeated. Meredith shrugged. "If I told you I wasn't, would you believe me?" Meredith questioned her person. "No." Cristina bluntly answered. "I wouldn't believe you." She paused insinuating. "Because I know you. And you are dark and twisty. You tend to be fine but in the end you are not." "So, what you are saying is I am not a bright and shiny person." Meredith said. Cristina nodded. "You are. We are." Meredith was quiet. After a moment or something, she said quietly: "Maybe my sisters are happy, shiny, bubbly people. Because they had actual parents and an actual childhood without ..." She didn't complete the sentence.

"I bet they are annoying. Happy, shiny people always are." Cristina pointed out.

Meredith laughed at Cristina's sassy answer. "You're talking about ..." "Izzie? Damn right you are. She can be quite annoying." Cristina said. "God, you are so mean." Meredith told her. "And you are not?" Cristina asked back. "Sometimes." Meredith admitted. "But you are right, sometimes she can be quite annoying. She really freaked out when she found out about this whole thing, you know?" She then told her. "She did, I know. Why did you run, Meredith." Cristina suddenly asked. "When did I run?" Meredith asked back. "When the whole Izzie thing happened, why did you do it? I mean, why did you endanger your life?" Meredith stayed quiet. "I am not suicidal." Meredith defended herself. "I know that you aren't. But why did you run?" Cristina was persistent.

"Why did I run?" Meredith echoed the question. Feverishly, she searched for a plausible sounding answer.

"I just couldn't stand there and let her walk over me like I am nothing." Meredith looked her friend right into the eyes. "That is why I ran away-" She faltered, unsure if she should continue. "And I won't let her do this. I am Doctor Meredith Grey, daughter of the great Ellis Grey, even though she she was a better surgeon than she was a mother, and I won't let her walk over me like that. I won't." Meredith breathed in, looked at Cristina. "So that is why you ran?" Cristina questioned her. Meredith nodded. She looked away. "Hey, Mer. I understand why you ran but please, I am asking to not to do it again. It can end badly and you know it." Cristina searched for a sign in her friend's face that tells her that Meredith understood what she wanted.

* * *

"Shepherd. What ..." She got out once she saw Seattle Grace's neurosurgeon lying on that gurney. "Dr. Derek Shepherd, suspected head trauma after car crash, he's awake and responsive - and not very kooperative." A paramedic stated the facts. "Oh, I see. But that's to expect." Bailey replied and then went over to the gurney. When Derek heard that, he scoffed. "I am fine." Derek said again, he ignored the headache that was pounding against his skull. "You fool. For starters, you have a huge gash on your forehead that needs to be sewn up. Anyway, why the heck are showing up in this ER all bloody. What happened to you?" Bailey wanted to know. Derek didn't answer. "I'd really appreciate an answer, Shepherd." Still nothing, God, he was really stubborn when it comes to his health. "'m fine." She got as a reply. Without another word, she grabbed a penlight and shines it into his eyes. When the light hit his eyes, he groaned slightly and tried to escape the light. "Guess why I don't believe you." She muttered under her breath. Suddenly one of her interns was standing behind her. "Dr. Bailey."

"Not now. Don't you see that I am a little preoccupied treating patients?" She asked back without even facing whoever asked her. "I am not a patient, I am fine." Derek insisted. "Don't do this." Bailey glared at him. "What?" Derek played dumb though he knew exactly what Dr. Bailey wanted. "The 'I am fine'-thing when you obviously aren't." She replied. "Are you really that dumb, McDreamy." This shut him up. Bailey grinned. Now he was quiet which would also be better for him.

"Now, what's wrong with you, Stevens?" She turned around to her intern.

"Why are you bothering me now? I have more pressing things to attend to." "Um ..." She said nervously. "Surgeons don't say um, Stevens. Now speak up." Dr. Bailey scared the intern. "I need a surgery." Izzie requested. "Please, I need to stick my hands into something bloody like a body. Please." She explained. "And why would I do that?" Bailey furrowed her eye brow. "Because I have nothing to do. Yang always gets the good cases. Burke even lets her scrub in on a and what do I have? Nothing. You are still punishing me for the thing with Meredith ..." She exclaimed loudly. Derek closed his eyes for a second, tried to shut Izzie's penetrating voice out but he didn't succeed. Blurriness clouded his eyes, for a moment the room seemed to be spinning. So, that meant head injury, definitely. He rubbed his temples to help them stop protesting.

"Could you please to stop that noise." He groaned suppressed. "It would be really nice."

Promptly, Bailey's attention turned to Derek.

"Are you okay?" She asked him, full in doctor mode. "She just needs to be quiet." Derek got out, ignoring the headache. "Stevens, go." She said to her intern. Izzie instantly started to protest: "But I ..." "Stevens, I said go. What part about that didn't you understand?" Izzie rolled her eyes and left. "Thanks." Derek mumbled. "So you're not so fine anymore, are you? Hm." She questioned him.

Derek grumbled, but never replied anything coherent.

"So I take this an approval." She said. She reran the penlight part because that's when Izzie disturbed them. "Okay, pupils are equal and reactive. That is a good sign. But just to be sure, I am ordering a head CT." "There is no need for that. I am fine. There is no bleed." Derek protested. "Ah, and you know that because you can look into your brain." She said sarcastically. "I knew if there was more than just a simple concussion. I am fine." He told her. "No headache, dizziness ..." She asked. "A bit. But it's okay." "Stupid, stupid, stupid." She muttered to herself. "Have you experienced any nausea or vomiting? Any vision changes like blurriness et cetera?" She inquired him. "I am a neurosurgeon, I know the signs of head trauma." Derek gave back. "You haven't answered my question." Bailey stayed hard. Derek sighed and answered, finally: "Blurriness, yes but not the other ones." Derek capitulated, maybe it wasn't a bad idea to do the head CT condering the headache that is pounding against his skull. Just to make sure everything was okay. That there really are no bleeders or other lesions.

"And someone needs to stitch up that ugly laceration on your forehead." When she sees blood dripping out of it, she bluntly complemented: "And it's still bleeding. I need to stop it. Gauze compress." She ordered, grabbing a pair of sterile gloves and then started examining the head wound. "It looks like it's superficial. Mark will stitch you up, okay?" She then told him. "What? There is no bleeding." Confusion covered his face. Immediately, Bailey was alarmed. Confusion was never good. "I am not bleeding." He said to no one specific. "Someone page neuro. And we need Sloan." Bailey ordered. When nobody came, she called out again. "Hello, are you all sleeping, there are lives hanging in the balance. There is no time for a coffee party." A nurse came and waited for instructions.

"Page Sloan, and neuro. Make it fast." The nurse nodded and did as Dr. Bailey said.

"I don't need neuro." Derek mumbled.

"Yes, you do. You're showing signs of a concussion, so yes, I do believe that that's neuro. Don't argue with me on this one." Bailey gave back, umimpressed. "God, Derek." She continued. She used his first name.

"In what situations are you getting yourself? Isn't it enough that Grey's down?" It was. It really was enough. But for the first statement he didn't have answer. So he just shrugged. It wasn't like he did it on purpose. It had been that damned bus that had rammed him head on. He didn't have a chance to swerve because every time he tried to the bus swerved too and made it impossible for him to do anything except getting hit. "It was the bus, not me." He lamented. Bailey looked up.

"What?" She asked him, scanning him worriedly and stopped doing what she was doing. She was worried about him being confused. "I am not confused, Bailey." Derek told the general surgeon as if he knew what Dr. Bailey had thought. He knew exactly what she thought. He was a neurosurgeon after all even if his brain momentarily needs rest. Her brows were furrowed and he knows he has some explaining to do. "The bus kept switching lanes. Every time I swerved or more tried to the bus did too. I had no chance." Derek answered the unasked question. "Follow my finger." She just ordered. "What … why should I do this? I am fine, really. I am." He repeated with a stronger voice. "And I'd be Santa Claus if I believed you." She answered in her typical Bailey voice. Derek rolled his eyes and Dr. Miranda Bailey huffed in response. "Follow my finger. I am only saying it this nice once." She held up one finger and he was supposed to follow it. "I can be very aggravating and displeasing if you not follow my orders."

"I am an attending …" Derek started but was cut off by Dr. Bailey.

"Wrong! First and foremost you are a patient in this hospital. My job as a doctor is it to make sure you are okay." She replied. "Now, follow my finger." Derek did as she said. To the right. Then to the left. Up. And then down. "Good." She said, the general surgeon scribbled something down. In all likelihood, his pupil response had been okay, he assumed. Otherwise Bailey would have said more than just okay. He snapped out of his thoughts when Bailey interrupted him: "Squeeze my hands." She told him. Without questioning anything or even thinking about complaining he did it. Derek gave Dr. Bailey's hands a tight squeeze with putting all the weight in it. "Okay, we're done. Now someone just needs to stitch up that nasty cut and then we have to see if CT's ready." Derek suddenly remembered that Meredith didn't know.

"Have you told her?" He quietly asked.

"No not yet. I haven't had the chance." Bailey responded a bit harsh. "Will you tell her that she shouldn't worry about me? I am only concussed. That's it." Bailey eyed him. "How am I supposed to do that? Tell me. You and I both know that she will freak out the minute she hears that you have been injured in an accident." Dr. Bailey said.

"Please just do it." Derek tried to get her to do what he wanted. She nodded. "How are you?" She then asked. "And don't you dare to answer with 'I am fine', Derek Shepherd. There is no way you can be." Derek sighed loudly and looked around. Right, he was still in the Emergency Department. But he avoided Miranda's gaze. He looked caught and the general surgeon knew it.

"Like I've been hit by a bus. That is how I am feeling. Curiosity satisfied?"

"A little more detailed please." Bailey responded, not taking her eyes off the neurosurgeon. "Any light - headedness, nausea or do you experience any other symptoms that are associated with blunt head trauma?" Bailey intervened and stared him down. "I am indeed feeling a little light - headed but otherwise I am fine. Honestly. When can I get out of here?" He then asked, all that while he was hopping off of the gurney. Miranda watched it with attentive eyes and knew what was dawning when she saw the neurosurgeon swaying slightly.

Derek was not prepared for that feeling, for suddenly feeling like he was floating. He swayed, for a moment the world was spinning around him. He searched for a halt as he suddenly felt Dr. Bailey grabbing his arm and stabilizing him. "Not so fast, Mister." She scolded him. "You will stay put until we know that you don't have any internal slow bleeding …"

"My abd'men is fine. You don't need to spend thousands of dollars on a CT that isn't needed." Derek protested, though he knew that he wasn't getting out of this. "We won't let you out of here until we know for sure that you are fine and all your images come back clean. We can then talk about that. So try to be a little more patient." Bailey advised him. His head was still pounding. "Derek." Suddenly Derek heard the chief's voice behind him. He was sure he was making an awkward picture. His legs were still a bit wobbly and he feels …

"What's going on with you? I've been paged down to the pit because some idiot bus driver couldn't quit driving with an alcohol level that high. Driver ends up hitting a car head on. Stupid, that is the definition of stupid. Endangering other people's life's … how come you are here." He frowned.

"… with a bloody head wound that needs to be taken care of." Derek laughed for a second but when he saw that it only intensified the hammering pain in his head he stopped. "You already said it all." He then replied. "You were in that car, isn't that what you are saying?" Dr. Richard Webber's face darkened. "What about the other passengers in the bus? Are they okay?" Derek wanted to know. "We don't know yet- we don't have any information on them. I am sorry, Derek." Dr. Webber answered.

* * *

"Grey. I have to talk to you." Dr. Miranda Bailey entered the hospital room. Meredith and Cristina looked up as soon as they heard Dr. Bailey's voice. They knew something was going on once they saw her face expression. Also, there was something in her voice Meredith and Cristina just couldn't place. Something was terribly wrong._** Derek.**_ He was the first thing that came into her mind. What the hell was going on?"

"What?" Meredith just stared at her resident in utter disbelief.

"There was what ..."

"There was an accident." Miranda Bailey replied. She sat up with a jerk. "An accident." She slowly repeated, the depth of the meaning of her words slowly entered her brain and "Oh, my ... Derek, is he okay?" She wanted to know, demanded to know. Miranda was about to answer but before she could say anything Meredith cut her off. "How did that happen?" She asked into the room, no one in particular. Her lower lip twitched queerily. "And why, oh no ..." She trailed off, her face expression was strained and filled with worry. Then it hit her. As a result her breathing quickened and she went pale. Derek's been in an accident. Someone really must be hating her when he throws all that crap at her. She just couldn't believe it. Maybe they're doomed. Maybe it's that. But then there is another thing.

She was the one who sent him to her home to get her some damned clothes ... How insignificant and trivial that now sounded. Because of her he got into this car, just because he wanted to do something nice for her. It was all her fault ... These words were over and over repeated in her head. Guilt trip light was coming the way.

She was being racked with guilt.

* * *

She saw the neat stitches on his forehead. The last time she had seen him linke this was - wait, she had never seen him like this. Vulnerable. Derek had always been the strong one. And now he was lying there, with a stitched head wound that had been bleeding profusely just minutes ago before the doctors stopped it from continuing to do that. Meredith swallowed hardly. Why the hell did this happen? Was this place freaking cursed or something? First Cristina's ectopic pregnancy, then the bomb, the whole thing with heart patient Denny Duquette, her surgery and the pneumonia - and now Derek. Mark had assured her that it wouldn't leave a scar, but the scar was the very last thing on Meredith's mind right now. Scar or not, it doesn't matter, she loved him anyway.

Dried blood could be seen on his cheeks. Nobody cared to clean him up. Meredith looked around in the room. Derek was in a regular room, these rooms were used for all non - emergent cases and surgical patient pre - and if stable enough to be moved, post - operative patients. It meant he would be okay. He was Derek, her Derek and McDreamy. Finally, her eyes catched what she wanted: paper towels in a box. She wetted it and gently wiped away the dried blood. When she was finished, she sat down next to his bed. But why the hell did this happen, or what was even more interesting why does it keep happening. She didn't have the answers to her question.

If she had, there wouldn't be any questions. Why the hell did this happen? Why? Maybe because the universe freaking likes to screw with her. Fuck universe, she thought. When will you ever get tired of this, when? Why won't you just let me live my freaking live. Was this place freaking cursed or something? Mark had assured her that this wouldn't leave a scar. But the scar was the very last thing on her mind. Derek was important. She grasped his hand. It was warm. She was relieved about this. He was alive. Despite she could she him breathe she found herself feeling his radial pulse. It was there and it was strong. The artery pulsated in regular frequent intervals.

She didn't hear Cristina coming.

Suddenly, she was standing behind her- "Cristina." She exclaimed when she noticed her friend. She didn't hear her coming. She was just there, without Meredith knowing where she came from. Cristina was watching her, she felt it. Meredith felt her friend's eyes in her back. Cristina touched softly on her shoulder. "He'll be okay. He is McDreamy. You will see him roaming the halls before you know it and he will charm everyone with his McDreamy attitude soon enough. He will be back to his insufferable self before you even know it." She said in a way only Cristina can. But it made her feel a bit better. At least a bit but it was better than nothing.

"Thanks." Meredith looked up.

Cristina shrugged as an answer but Meredith knew that she shouldn't take this personally. For a while, nobody said anything. Then Meredith said: "I feel like this is my fault. I asked him to drive to my house and …" Before she could continue, Cristina huffed.

"You haven't actually found a way to blame yourself for an accident, have you?" Cristina said aghast.

Meredith looked to the ground, unable to look her friend in the eye. "Oh my god, you actually have found a way." Pause. "C'mon, Mer, these things happen. It is not your fault that he lies here. It's the driver's fault that hit him head on. He is the one to blame but not you." She said with a strong voice, hoping her friend but be convinced. Meredith nodded. "I spoke to Bailey." Hearing that, Meredith looked up. "She says he will make a full recovery. He has suffered a mild concussion, that's all. The other images showed no evidence of other internal injuries." Meredith didn't answer. No other injuries. So that is good. She can deal with a concussion. They can together. He was just sleeping, she reminded herself. Then Cristina also told her that the brain scan showed no evidence of bleeds or any other kind of lesions. But maybe they need to do a second. There was always the risk of slow bleeds.

"But what about slow bleeds?" Meredith couldn't help but shudder at the thought of that. "Meredith, the images came back clear. No other injuries but a mild concussion that will resolve itself with a lot of rest, and sleep. He knows what to do and what not, he's a neurosurgeon. But he is okay. Everything, every image they took came back clean- there is no need for you to beat yourself up about this."

"That's good." She responded, she seemed kinda overwhelmed by all the sudden changes that seemed to be coming out of nowhere and then hit her with full force and there was nothing she could do about it. "Mer." The firm tone in Cristina's voice caused her to jump up and face her friend. "Yeah?" She asked. "Are you okay? I mean, are you really okay?" Her friend wanted to know. "'Cause you seemed pretty out of it when Bailey told you. You still don't look that good." She motioned to sleeping Derek who had a bandage covering his head as she was speaking. "I don't know what you are talking about." Meredith responded vacantly. "I am fine." She said. Cristina sighed.

This was to expect. Meredith was shutting other people out. "Page me if you need anything." She said before she left the room. For a moment, Meredith looked after her. "Mer." He croaked. His blue eyes were fixating on her. Meredith gasped. Joy flooded through her veins. Derek was back. She couldn't describe her feelings. Tears gushed out of her eyes and rolled down her cheeks. He was back. He was back and he was okay. Going to be okay, at least.

* * *

"I'll be okay. No worries." Derek said as he slowly pushed himself into a sitting position. His head was still hurting but since the images Bailey insisted on came back clear with nothing but a moderate concussion, he knew it would stay like this for a while. But luckily there weren't any more nausea flare - ups, he was way past it. "I know you will be. We will be okay." Meredith said, lowering her voice out of sympathy for him. She remembered the pain she suffered from when she had the whole migraine thing going on. And right now, he was the one with the headache resulting from the crash. She still couldn't believe how *lucky* he had been to get out of this with only minor injuries. He easily could have died. He could have died in the car wreck. His car was now completely totaled. She shuddered when she thought about that. He really could have. But he didn't. Together, they keep beating the impossible odds. They have been incredibly lucky.

There were so many situations that could have gone so terribly wrong …

"You should be resting too." He blinked as he focused his gaze on her, his blue eyes were now fixated on her. "Sssh." She just kissed him. It was her way of shutting him up. "Sitting up is good for me. Derek, you've heard Burke saying it yourself." She then said, explained in a distinct voice. "But you should." Meredith added with a worried glance at Derek. She watched him, Derek avoided her gaze. Why he did it, he didn't know. "I am fine." He backed away. "Derek, you've been in a crash that easily could have killed you. Easily, I mean that you got out of it like this is a miracle by itself. It really is. But you are still …" "Mer." He softly ran his finger over cheek to stop her rambling. He had survived, Miraculously, he had. And she was - she couldn't describe her feelings.

"But it didn't kill me. I got out of this with only a concussion. I'll be back to my old self before you know. I am okay. I really am." Silence. Suddenly, there were tears welling up in her eyes. She couldn't control it, she couldn't do anything about it.

"Mer, what's going on?" He asked, he softly lifted up her chin so that she looked at him.

"I thought … I really thought … for a moment …" Her breathing rate rapidly increases. They came out in short, panicked gasps. Shallow. She tried to suck in air but her lungs wouldn't cooperate.

"Meredith, Meredith." He tried to get her attention as she struggled for air. "Meredith, I need you to listen to me." He said as clearly as he could. He has to stop her. If she keeps breathing like this, she will hyperventilate. Meredith looked at him, still trying to breathe. "Breathe. Meredith, slow down and take some nice deep breaths for me." He drew circles round her back to relax her. Slowly, Meredith's breathing slowed down.

"Thank God." Derek exclaimed. "You really had me worried here." He confessed. Meredith turned to him and went forth with a quiet voice: "I thought I had lost you." She almost cried as she choked out these words. "When Bailey told me, my heart almost stopped …" She trailed off … "Not funny." Derek mumbled to himself. Meredith didn't seem to notice what he had said, apparently his voice had been to quiet. "I was like paralyzed and wasn't able to think clearly. Cristina had to drag me away from the CT room so that I wouldn't encumber anything when they took your pictures. I … was …" Derek just grasped her hand and pressed it slightly. Meredith tried to form a smile but somehow she just did not succeed.

"I love you." She whispered into his ear. "You're the best thing that ever happened to me. You make me feel things I never knew they even existed. Because I have you, I know what it's like to be loved, actually loved. The kind of love that wants you to spend your entire life with the guy." She never speaks that openly about her feelings. Meredith does not talk about things, she avoids. But now she didn't. Derek couldn't believe it. She felt the same way as he did. But they needed to take it step by step. There would not be any rushing with things. This whole thing really had had an impact on ger too. He knew that now. "So I need you to not do this again." She finished shaken up. "I need you." She added a bit quieter. Derek whispered: "I'll try not to get hit head on or in any way. I'll try. And, Mer: I love you too. But you knew that right? We will take these steps slowly. No rushing. I promise." He looked at her with his blue McDreamy eyes.

"Ow." Derek's voice sounded muffled.

Meredith noticed the strained expression covering his face. Of course he tries to put on a brave face for her but she knew he was doing this. "Does it hurt?" She asked, immediately he saw her tiny frame hovering above him. She couldn't help but notice to slightly pained expression on his face which was slightly pale in comparison to his normal color. "A bit." He confessed. Derek avoided her gaze, he was probably a bit embarrassed for showing weakness. "It's okay, the pain will stop. Just try to sleep." Meredith quietly suggested. Derek seemed to consider it. Soon after, he closed his eyes and tried to sleep. He knew Meredith would still be there when he wakes up. His eyelids dropped and Meredith watched him drifting off into a nice sleep. Life wasn't taking it easy on them, so much was clear. But they knew for sure: Whatever crap the universe throws at them they will get through it together.

* * *

**_A/N: Hey, this comes a little delayed, I know.  
_**

**_Hyperventilation occurs when the rate and quantity of alveolar ventilation of carbon dioxide exceeds body's production of carbon dioxide. Hyperventilation can be voluntary or involuntary. When alveolar ventilation is excessive, more carbon dioxide will be removed from the blood stream than the body can produce. This causes the concentration of carbon dioxide in the blood stream to fall and produces a state known as hypocapnia. The body normally attempts to compensate for this metabolically. If excess ventilation cannot be compensated metabolically, it will lead to a rise in blood pH. This rise in blood pH is known as respiratory alkalosis. When hyperventilation leads to respiratory alkalosis, it may cause a number of physical symptoms: dizziness, tingling in the lips, hands or feet, headache, weakness, fainting and seizures._**


	25. Chapter 25

**Chapter 25**

* * *

**There's a reason surgeons learn to wield scalpels. We like to pretend we're hard, cold scientists. We like to pretend we're fearless. But the truth is we become surgeons because somewhere deep down we think we can cut away that which haunts us. Weakness, frailty, death. It isn't just surgeons. The truth is I don't know anyone who isn't haunted by something or someone. And whether we try to slice the pain away with a scalpel or shove it in the back of a closet- our efforts usually fail. So the only way we can clear out the cobwebs is to turn a new page or put an old story to rest - finally, finally to rest.** Haunt You Every Day; Meredith Grey

* * *

Meredith snuggled against Derek. "Today I have to meet him." Meredith suddenly said. "What ..." Meredith noticed Derek was only semi - awake. "Are you ..." She asked, eyeing him suspiociously. "I'm up." Derek said and yawned. His blue eyes were looking wearily at her. He was tired. She knew it, however, she still decided to talk to him. "I have to meet him." She said. "Him?" Derek asked back. "McSpermDonor." She answered. Derek sat up, half erupting in loud laughters. "What did you call him? McSperm ..." He couldn't finish the sentence. "You really named him that, did you?" Derek wanted to know. "It was Cristina's idea not mine. But it fits. Because he is not my father ..." She trailed off. "Should I ..." She wasn't sure if meeting him was a good idea. She would want to meet him some time, yes but yet? Isn't it a bit to soon for that? At least waiting a few weeks, let everything sink in. Time to fully comprehend what is going to happen ... "Should I really do it?" She asked, looking at the wall. "It's your choice. A choice that I can't make for you. You have to decide for yourself what's best for you, you know." He tried to tell her. "Do what you think is best for you. Don't let others make these choices for you." Meredith nodded.

"What is it like to have a father?" She quietly asked, not knowing that this question hits him close to home. Not knowing that she stirred up a hornet's nest with asking him that question. Derek flinched when he heard her question. His breath caught. No. He couldn't talk about that yet. He just couldn't. Meredith has hit a sore point of him. One that he still couldn't think about without feeling totally helpless. Why did she have to bring it up? Now, why now? Derek Shepherd did not get it, why now. Why does she have to ask that question today? Maybe because she never had a dad, someone she could call 'daddy' and who has been there for her throughout her whole life. "Derek." He heard Meredith's quiet voice, calling his name. She was worried. Why did he react like this? Was it her question? Has she done something wrong? She couldn't figure out what. "I am sorry, Mer." He said abruptly, standing up, he paced up and down.

"I can't talk about it right now, I just ... I can't." His voice sounded a bit harsh. But also sadness and pain was written on his face. Memories. She brought memories back. that's what it has to be. Oh, damn, why does it always have to be that she always ruins everything good in her life? Why? Meredith was shocked, she stared at the wall, trying to make sense of the situation. Something like that never has happened to her. So what was it. Meredith looked at him with big eyes.

With that, he left the room.

Meredith just sat there, completely frozen. What did just happen? It was her, it has to be. She has done something wrong, somehow ... "Hey, Mer?" Someone called her name. Meredith cringed when she heard it. "Mer, is something going on?" The voice asked and she could tell that whoever this was, was worried. About her. But she didn't care. What was going on with Derek? Why did he react that way? Then she heard someone walking into her room. She was no longer lying in a room in stepdown unit, she has been transfered to a regular room. "Mer." Now she recognized the voice. It was Alex. Meredith looked up. Into Alex's eyes. "Are you okay?" He asked while he controlled the indwelling cannula and the infusion drip. "Looks good. Now, what happened?" He softly asked.

"Nothing. I am fine." Meredith replied somewhat too hastily. Alex noticed that. "C'mon, Grey, it's just me." He said. "Okay, I asked him a question and now he is gone. And now, I didn't ask him to marry me if that's what you think." Meredith answered. "I wasn't going to think this." Alex said. "Good." But she didn't say what was going on. Alex didn't know what to do. This was Cristina's job. He didn't know what to do. Cristina is the one who has to figure it out. This is Cristina's kind of thing, the twisted sisters thing. He has no idea what to do. Finally he decided to cautiously ask what was going on. Not knowing whether she will answer or not, if she wants him to be quiet or if she talks. "Mer, hey." He said a bit louder but never even flinched - not even a bit. She just sat there, wondering what she had done wrong this time. What was it that caused Derek to run.

"Mer." No answer. Alex sighed.

He tried one last time to get her to talk: "Mer. What is going on, is it him? Talk to me. Should I get Cristina?" He asked but he never received an answer from her. She just stayed mute. Alex sighed. This wasn't getting them anywhere. He pinched her in the arm - just lightly - hoping she would snap out of it. So he tried it with pain stimuli. That this would bring her back to her old self. "Ouch." She exclaimed, rubbing her arm where Alex had pinched her her. Finally, she was looking at him. "What the hell was that?" She asked staggered. "Sorry .." He shrugged. "It was just ... you wouldn't stop staring at the freaking wall ... so I made you stop with a little help of pain stimuli." He stated bluntly. "You were starting to freak me out." He added.

"Fine." Meredith fumbled on her i. v. access to get it out of her arm.

"I need to talk to him." She repeated, looking around the room a bit hectic. "He Has run off and ..." She was nervous, Alex saw that the way she acted. She kind of looked like a deer caught in the headlight of a car. She was about to get out of the bed way to fast. Alex saw it coming and called out: "Meredith, wait, what the heck are you doing? Whatever it is that's bugging you, don't do this. You're gonna hurt yourself." Alex reacted and stopped her from getting up.

"But I have to ..."

"You have nothing to do but to lay down and stop stressing yourself out. It's better for your blood pressure ..." Alex faced Meredith. She answered: "I've never had trouble with my blood pressure. It's never been to high, to low, yes but not to high." Alex ignored this comment. "Please, Mer. Tell me what is going on. I'll try and fix it." He said. Meredith still tried to get him to loosen his grip around her arm but Alex Karev was way more stronger than her (and he didn't had surgery days ago which was another factor in things concerning her strength). "Damn, Karev." She muttered as she tried to free her arm. "Meredith." He said sternly causing her to look at him for a moment. "I am saying 'please' here, Mer." Alex tried to assure her.

"I have to go after him ... I can't meet McSpermDonor without having his back, without knowing that he's ..." Who is that mysterious 'he'? He bet it was Derek Shepherd Meredith was talking about even if he had trouble following her weird sentences and wooly thoughts. It has to be Derek, it's always 'bout Derek when she acts like this.

It's like a rule or something.

"Is it Shepherd, Meredith?" Alex urged her to answer. Tried to get as much information as he could possibly get out of her but that wasn't very easy- "Is it about him, is it Shepherd? Did he hurt you ... Should I ..."

"No, no, no, Alex. It's fine- I just need him back here. Telling me that everything's going to be okay." Her voice sounded shaken up but she tried to hold herself together. "I am worried." She said. She finally talked. "About him, you know." Alex gave a slight nod, signaling that he understood. " When I asked him about his dad ... asked him about what it's like to have a dad, a real dad, supporting you the whole way throughout your childhood ... he just ... I don't know where he is. He just ran off ..."

_Oh, Derek, what have you done ..._

Meredith was now sounding completely helpless. "It's gotta be okay, Mer." Alex reassured her. "I'll take care of that situation and you relax while I go figure this out." Meredith nodded. "It's okay. I'll find him but don't get out or pull that out." He pointed towards her intravenous line. "Fine." Meredith said stubbornly as Alex turned to her, once reassuringly smiling at her before heading to find Derek.

"Thanks, Alex."

* * *

Mark Sloan and Derek Shepherd were both sitting against a wall. For a moment neither of them said something. Then Derek interrupted the silence. "She asked me something." Derek suddenly said, tears shimmered in his eyes. "Something that brought back horrible memories. I freaked out ... I ... I don't need a reminder of what happened. I don't know if I can tell her about what happened." Derek looked at Mark. "Okay, first of, you're talking about Grey?" Mark wanted to know. Derek nodded, for a moment he closed his eyes. "And she asked you a question. What question ... "

Mark Sloan nudged his shoulder.

"Hey, man, are you okay?" He asked when Derek did not respond.

Then, without answering the last question, Derek said dully: "She wanted to know ..." He stalled and inhaled sharply. "What it's like to have a real dad ... that was her question." Mark let the question sink in. He knew why Derek was acting like he is. He knew the reasons. He has known Derek since elementary school, they've been best friends ever since. He had supported Derek after it happened, to get through it ...

"Oh." Mark frowned. "You never told her, did you?"

Derek shook his head. "No, I didn't, I was going to but then I didn't." He buried his face with his hands.

"If I tell her now, she'll think that I think she is an insensible bastard. I know she will. But she isn't, she didn't know- I am the insensible bastard. I ran off, letting her think god knows what ..." Derek said like to himself. "Hey, stop it." Mark said. "I can't answer these questions. I was only ten years old, I don't ..." Derek didn't seem to hear what Mark said.

"Shep, you're strong. You've made it that far ... She would want to know, I know she would. She loves you. You could just tell her. She ..." Mark was interrupted by Derek who sent him a silencing glare as he noticed Alex Karev standing there.

Alex Karev found him sitting, leaning against the hospital room. It was not even far away from Meredith's room. Derek and Mark were talking in a quiet tone. Alex Karev cleared his throat as he came nearer to them. "I don't mean to interrupt ..." He shifted uncomfortably as he trailed off. "Then don't do it." Sloan replied sharply. Dryly. "Speaking of which, can you bring us two coffees from that vending machine downstairs? The one's on this floor is out of action. That would be really nice." Alex eyed the plastic surgeon. "You want me to bring you coffee?" Alex asked them but looking at Sloan. "Did I hear that correctly?"

"Good boy, you learn fast- Make it a double." Mark grinned at him.

"No." Alex replied shortly, not caring if there were consequences awaiting him.

"In fact, I won't get you your stupid coffee. If you want coffee go get 'em yourself. I am not even on your service."

Alex paused, his eyes sparked.

"I am past the whole coffee and muffin thing. You are great man, Sloan, but you get coffee yourself. I may be an intern but I don't do the whole coffee thing. If I am on Robbins' service I don't need to bring her coffee. And I learn something. SO it would be a good idea to try and get it done yourself if you want a coffee so badly." With that Alex turned to Derek.

"As for you ... Derek, I don't get you, I really don't. But you know what? Your girl is in her room, worrying herself to death, driving herself crazy because she thinks you might have left her ... She is blaming herself over things that aren't her fault. She is going crazy in there, she thinks she has done something wrong. In short, she is an emotional wreck and the cause of all that is you." He finished his speech and looked at the faces of the attendings, focused on Derek aka stupid brainman without a brain. Who was in fact acting very brainless sometimes. Brainless brainman is the phrase Meredith would use.

"Oh, crap." Derek called out.

"I totally forgot that I ..." He inhaled and continued after a few seconds: "I was so focused on my own problems and didn't even remember that I left without even explaining ..." He looked up- suddenly, he remembered that he ran off, leaving a distraught Meredith behind who didn't know what was happening or why it was happening. "You have one hell of explaining to do, dude." Alex. "You should be pull yourself together and go back in there and this time, make it right." Alex advised.

Derek made an unsure movement of standing up but his thoughts, his brain wasn't focused on what he was doing plus the whole concussion thing going on wasn't very subserving for the whole situation. Which was what caused him to sway a bit. He clung onto the wall for support as he tries to steady himself.

"Are you okay, man?" Mark asked worriedly, even Alex tossed a worried look at the neurosurgeon.

"Are you ..." Alex adressed as Derek looked up at them.

"Are you sure that everything's okay." Another fucking question. "Okay." Derek said as he was standing on steady ground against. "This is normal, in case you have forgotten about the whole car thing. 'm fine, just a little dizzy is all. No need for you to worry." He steadied himself by holding onto the wall. Mark and Alex exchanged worried looks. "I am fine." Derek repeated a bit louder. He let go of the wall and stumbled towards Meredith's room. Alex followed him. "Are you really sure that your okay, man?" Alex questioned him.

"Can't you just leave me alone?" Derek hissed at him-

"Don't you have any babies to deliver?" Irritation or sudden emotional changes and changes in behavior can be a symptom too. Alex knew that. Rigorously, he shook his head. "I am busy trying to figure out a way to make that McDreamy ..." He points at Derek. "... gets his act together." Derek didn't reply, he just looked to the ground ruefully. He didn't let his eyes off the neurosurgeon as they made their way back to Meredith's hospital room.

As soon as both of them set their feet into Meredith's hospital room, they saw her sitting on the edge of her bed, fully clothed. She was not only wearing a thin hospital gown but a sweater and some normal pants. "Mer ..." Alex said flabbergasted. Derek was too shocked to speak. Why would she be in normal street clothes? She was a patient ... but then he remembered that she was meeting her father. "Mer." He said, his voice nearly breaking. It sounded a bit strange.

Meredith turned around. "Derek." She said a bit cooly. Derek bit his lip. He knew he should have expected that she would be harsh but somehow he just didn't think about it. "I am sorry. I am so, so, sorry for running. But ... those memories, I just couldn't bear it any longer. I ... I am sorry."

Their eyes met.

Before Derek knew it, he sat down to her and grasped her hand. "I didn't leave you, Mer."

Meredith looked at him with big eyes and nodded: "I have to go and meet him - down in the cafeteria. Do you think it will be okay?" She looked at him, searching for an answer. "Yes, it will be." Derek's voice was strong. Without a reply, Meredith just came nearer and nearer to his face. Their lips touched and a long kiss followed. Alex slowly disappeared, his mission was fulfilled. Meredith and Derek were happy again. They just needed a little help finding each other.

"I will tell you sometime, I promise." Derek whispered sofly.

* * *

"Hello." The man said when she arrived at the table. He looked nervous. "Hello." Meredith replied, unsure of what to say. This was awkward. Neither of them said something. They just looked at each other, trying to sort out the mess in their heads. So this was her father. Meredith gawked at the man who is supposed to be her father except for the fact that he wasn't her dad. He had never been there for anything. He was supposed to be there for her throughout her childhood that hasn't even been remotely easy. Now he was here but almost thirty years too late. He should have been there to all the dance recitals, high school graduation, even fifth grade graduation that isn't even real but he was supposed to be there. He should have been there. Now he was here. Now he just was a man with greyish hair who just got her mother pregnant with her. He was nothing more than just a sperm donor exactly because he had never been here for anything.

"I should be with Derek right now and instead of being with him I am here." Meredith said after they just keep staring and gawking at each other. Why am I here, what am I doing here? She asked herself. Thatcher just looked at the young woman. He didn't know what to reply. He knew this was not going to be easy. This mess, this whole situation wouldn't be easy. She would not make it easy. And he was right with assuming this. Meredith wouldn't make this easy for him. And the worst part of it was that she was right. He had never been there for her, he left before Meredith was even born. "Then why are you here?" He asked back. He was shifting uncomfortably. Meredith noticed his uneasiness. She shifted from one foot to another and so did her so called father. Or should she call him sperm donor? She didn't know the guy. Thatcher Grey was – is – just a man who is somehow related to her.

"So …" He said, looking at her expectantly. "What so?" Meredith asked back, alienated. He was making her feel insecure with his out of sudden appearance. She never asked to meet him after he never even bothered to visit or send cards on birthdays or Christmases. "So … maybe we should talk." Thatcher slowly suggested. He glanced at her. Meredith's mouth opened and closed.

"Maybe you should start with explaining. You have a lot of explaining to do." She got out.

"I can't … I am at a loss of words right now. So if you want to talk, talk. I am here and I am listening because it's only fair that you get your chance." Meredith got out. I can't even look at you right now without my stomach churning, she thought. Thatcher Grey swallowed and cleared his throat. "I don't know how to begin." He muttered to himself. God, that was downright pathetic. He was sitting there in front of her and didn't know what to say.

"What do you want to know?" He asked but he knew instantly that this had been the wrong question to ask. He shouldn't have asked this question. He shouldn't have, really. He knew that when he saw the disgusted look on Meredith's face.

"Why are you here?" She asked back, "I mean if you are here you should at least know what you want to say to your daughter that you have left behind so many years ago." Silence. "Why do think now is the right time to come into my life when you should have been here at least since I was born? But where were you? Not here. You should have been there for me throughout my childhood. It's what fathers do." She started confronting him. "I know." He said without thinking first. Meredith glared at him. She couldn't believe what she just heard. Why does he have the freaking nerves to say something to his abandoned daughter? Hello? "How can you?" The question was in the room. Silently, Meredith waited for a reply. But the longer the waited for a potential answer, the more she let go of it. "I can't and I am sorry for what I have put you through …" "Oh, are you?" Meredith cut him off. "Then why didn't you do better? Why did you leave? Wasn't I …"

Now she was fighting against breaking down in tears.

Her eyes burned, she felt her cheeks reddening. Meredith stared at the wooden table.

Damn it.

"Wasn't I worth it?" Thatcher swallowed hardly. That was a question that hits close to home. Why didn't he? He didn't have the answer as well. Thatcher's mind was empty.

This is getting more and more difficult with each second.

"Why was Molly worth it and I wasn't?" Peng. Another question that hit him like a ton of bricks. Thatcher felt his insides turning when he thought back to the question? How can she possibly know about Molly and Lexie. "Don't you do this, don't bring my children into this." He said. Meredith felt nothing. Molly and Lexie were his children. She was not and nor she will be. Her father wasn't interested in her. "How do you know about them?" He asked quietly, looking almost staring at the table. "I was the intern on Molly Grey's case. That's when I first … Anyway, we talked. About her marriage with Eric and the ring and that she has an older sister with a photographic memory named Lexie who goes to med school. Harvard. She just knows my name's Meredith, she does not know about the Grey part. That is your story to tell, not mine." Meredith normally wasn't that emotional. Normally she was a whole different than nowadays. Especially in this particular situation she was not her old self.

"Why did you leave?" She finally found the strength to repeat herself.

"… before I was even born?" She quietly finished her most pressing question.

Her voice shook- Thatcher Grey still hadn't answered it. She shuddered slightly, for a second and closed her eyes. Thatcher watched her and decided to ask. "Are … you okay?" Her whatsoever asked, trying to get through to her. When he noticed the discontinued intravenous line and also discontinued the central line in her left subclavian, he didn't know what he should do. She was here as a patient? In this hospital, some of the other doctors told him that she was a surgical intern. Did she need surgery too? Meredith slowly opened her eyes again, for a second she felt light - headed. She was sure it was because of this situation. It can also be her body's way of telling her to slow down things, she needed to take it easy. She was still recovering from a major procedure. Uneasiness creeped through her veins. This conversation wasn't going the way she had imagined to go.

"Do I look okay to you?" She kind of snapped at her him when she had registered he had asked her a question ."Em." He just responded, gazing intently on the table. As if he was overly interested in what color the table had.

"Do I look … I am twenty one days post - op open heart procedure. Does that sound okay to you?"

She didn't even wait for him to answer. Her blood boiled.

"Heart procedure?" He repeated. He had no quite the idea what she meant with that. "Yes, open heart surgery. You have heard correct." He breathed in sharply. Oh, no, this was not good at all. "You want to know the reason? I bet you do. Don't you?" She directed this question to him. No answer. "You won't ask but you want to know it anyway. But you deserve this information, if you will ever give a damn … I don't know." She trailed off.

"What are you talking about?" Thatcher asked confused.

He didn't get what she was talking about, he had no idea. "I am telling you anyway."

The silent 'why' was hanging there, left unsaid. Meredith paused, Thatcher looked down at the table, wishing desperately to disappear. He knew had had made a huge mistake he had done. He wasn't sure if Meredith would be able to forgive for what he had done to her. But he hoped she would give him the change to get to know her. Eloquent silence, before Meredith started speaking: "I shouldn't be saying this, I know. It's mean and unfair. But I can't. I will tell you that thing. To make you feel guilty. To make you feel more guilty tan you already feeling." Meredith said sharply, she stopped to let the words sink in. "Oh, God. Now you must think that I am terrible, that I am terrible person." She starts rambling. "No, it's okay. You have every right to say that." Thatcher said. He diminished slightly on his chair and prepared himself for what was about to happen.

For sure it was not something small.

Meredith's eyes beholded on Thatcher. He dipped his head, no longer able to face her.

"I was born with a CHD." Meredith quarried out.

Silence.

Meredith suddenly stood up. "I need to go, I have some things to do. Nice meeting you." With that she was gone. She disappeared from the cafeteria, Thatcher looked after her until he didn't see her anymore. Until she was out of sight. He had screwed up, really screwed up. Lexie wasn't talking to him, right now, they weren't exactly on speaking terms. Molly and Susan never say anything but they look at him. And Meredith ... well, that's one hell of a piece of work.

* * *

Cristina crammed some money in the vending machine. She was hungry but she had no intention of going to the cafeteria to eat. Due to the fact that Meredith was there, meeting her father for the first time and she doesn't want to intrude. She hoped this one would be working. Because the vending machine on the other floor was not working. It had put out of action and there wasn't a sign or notification or something that ells you this machine isn't working right now and that it can't be used. But no, there was no sign. Somewhere down the line she got fed up with the machine and discovered that it has been shut down. But hey, this time she seemed to be lucky. This vending machine's working.

She pushed a few buttons and waited for the food to drop out.

With a thud, the power bar and some sandwiches plus a bottle of water landed and Cristina bent down and grabbed it. Then she made her way to the tunnels. Normally, she was there with Meredith. It was their place. Sometimes Izzie, George and Alex were there too. But with Meredith talking to McSpermDonor she was prepared to eat alone.

But she wasn't alone. Izzie was there too. With George. Alex was somewhere she didn't know where. Cristina made a beeline for the gurney and let herself fall on it. For a moment she just lays on her back and stared at the wall. She then sat back up, stretching her arms. Izzie was watching her.

"What is it, blondie." She asked without turning to her.

Izzie scoffed. "I am good. Thanks."

"Doesn't look like it. You look like you would burst out into fire at any moment." Cristina stated bluntly.

"How is she?" Izzie asked, looking to the ground.

"I am not telling you. If you want to know, why don't you go and ask her yourself." Cristina shrugged her off. "You know what Cristina, right now, right now in this moment, I don't like you." Izzie told her bluntly.

"Oh, I think that's based on mutuality. But don't ask me, 'cause right now I don't like you either."

"I never wanted it to happen." Izzie protested.

"Lame excuse. What's your point in doing that? I mean, you already know that I'll have the last word."

"Just shut up." Izzie hissed.

"Fine." Without another word, Cristina bit into her power bar and opened a book about cardiothoracic surgery. George just sat there, watching them how they get on each other's nerves. It was cold before Cristina got here but now with Cristina and Izzie in one room, it's all heated up - noticely. How much longer will they do that? It's starting to annoy him. So he decided to say something into the silence they were in: "Could you please just be friendly for a day? It's been what, three weeks between the incident and now ... I mean it can't go on like that. We have to get ourselves together and work out some solution. Because it can't go on like now." George was now breathing heavily.

"It can't, I am sorry. We need to crack it. We need to get over it and focus on what is coming."

Pause.

"Cristina, I know you're blaming Izzie but here's the thing, it won't help matters."

He turned to Izzie.

"Same goes for you. I know you are mad at Meredith for never saying anything about the CHD but do you know that you have a big mouth sometimes and if you would have said anything to anyone the whole hospital would have known - accidently - but my point is, don't let it affect our friendship. I mean, currently there are some hardships but we'll get through them. We're MAGIC. We can do it without growing apart ..."

He sighed deeply. "I know we already do, but at least try. For me. Because I am not mad at Meredith. I get it. I get why she didn't tell us. But some things are better off if being left in the dark. That is what she thought. Even if she is wrong about it, she is still my friend, one my closet friends." George looked at Izzie and Cristina who were both silent.

"Don't let it end that way. That's all I am asking. Get. It. Together. And. Pick. Up. The. Freaking. Pieces." With that George stomped off. It had astounded them, George's speech really had astounded them. Cristina was amazed, genuinely. Even Izzie looked like she would consider talking about her problems ...

* * *

Meredith waited for the elevator. She wanted to get out of this hospital room. This time, she had told the nurses where she was going to be. She wasn't about to do the same mistake she'd done before she had the cardiac procedure. And it almost ended deadly for her. Meredith Grey was headed to the cafeteria, Derek was somewhere with Mark. She had convinced him to do something she wanted to do and since her state was pretty much stable and it only went upwards since a few days, he agreed. Stubborn as he was it had taken her a while to convince him but she succeeded. Now she was impatiently waiting for the elevator. She was using a wheelchair so she wouldn't not put any strain on her incision. Ripping the incision open would one mean setback a few steps and she wanted to avoid that. So she followed post- op protocol. But she still worried about him. It has only been a few days since he had been in that accident. Even if he only suffered a mild concussion. Also, Mark was there too and Derek was a neurosurgeon, okay, even when his judgment can be clouded due to the whole concussion thing going on. Even if he claims to be okay. Lack of judgment can be a symptom too. Meredith was pulled back to reality when when she found herself in front of the elevator. She waited impatiently to get on it. But the elevator was one of the slowest ... Which means waiting. Slightly annoyed she looked around and half - listened to two doctors who were talking about a case.

Then the elevator doors opened with a loud ding, that sounded like pling. Meredith was about to wheel herself in the elevator but voice interrupted her by doing this: "Wait, let me help you." The voice belongs to a young woman. Younger than her, she thought, maybe three or two years. She was pretty, had short black hair and a sweet and friendly smile. She looked like a nice person. The black-haired woman wheeled her in, then she asked her where she wanted to go. Meredith smiled at her, she was thankful for her help. Cristina was not here, Derek was somewhere with Mark and the others, she didn't know, maybe they were in the operating room or the emergency department covering the pit or maybe they were doing charts.

"Thanks." She said towards the woman. The woman should smiled friendly and listened to her. "I am going to the cafeteria. I just needed to get out of that room." Then Meredith shook her head: "Sorry for bothering you. You probably didn't wanna hear that. I ... I am sorry." She apologized hastily, her voice was slightly chastised like she was a little child that has done something wrong. The black-haired noted the embarassment of her and smiled kindly before she replied. "No no. It's fine, it's okay." The other woman replied. "I kind of had a crappy day too."

Pause.

"But I bet it wasn't as bad as yours. I mean these central lines et cetera don't look like they were comfortable." She said, pointing to the discontinued central line on her left subclavian. Meredith didn't know if she should say something to comfort her. What was this with this woman? Why was she feeling like she would know her from somehow. It was weird, really.

Then she decided it was worth a try: "Do you wanna talk about?" She asked cautiously, maybe the woman would freak out on her for asking for such intimate details of her private life. But she just sighed loudly and then said: "My father was married before he married my mother. Which wouldn't be that awful. They divorced and then he met my mother." The woman breathed in and looked at Meredith. She gazed at her as if she had seen her before ...

Okay, where was this going? Meredith didn't know. She just listened to the younger woman's babbling.

She was kind of rambling. Meredith seemed lost in thoughts ever since they had done the test to see if she really was Thatcher's daughter. And the results came back positive.

"Now my father has another daughter. They did a test to confirm the results ..." She laughed, fake and emotionless laugh. Meredith shuddered. Was this girl her half sister? Was she? She didn't know her name. "I don't even know if I want to meet her? I mean, what if she doesn't like me or doesn't want contact?" She wondered out loud. Meredith didn't reply. She just wanted to disappear. If this girl was her sister, then she probably won't even get the chance to meet her. Then there was a pling and the elevator doors opened. The girl left the elevator. "Bye." She said. "Bye." Meredith replied.

Then their ways parted ...

* * *

_End of fourth week: _Meredith and Cristina could not stop laughing. They didn't even exactly know why they were laughing. Maybe someone cracked a joke or something like that. "Oh my God." Cristina said breathlessly between a few laughs. "Make it stop." She pleaded her friend but Meredith was helpless as well. "I cannot stop." Meredith said, snorting, although both Cristina and Meredith eventually calmed down after a few minutes. "Good. Now I can breathe …" Cristina said. "Normally." Meredith deadpanned. Dryly. "Not so funny." "Oh, you can't – that's not really funny, that's right? Should I call someone?" Meredith sounded deadly serious. "No." Cristina stared at her friend. "I am great." She said. "Good." Cristina rolled her eyes when she heard Meredith's reply. After some time, both calmed down. Just in time they did before Dr. Bailey, accompanied from Derek and Dr. Preston Burke, entered the hospital room. Immediately turned Meredith and Cristina turned their attention to them, awaiting patiently what was coming.

"Maybe they will let you out of here. Sooner than you thought." Cristina whispered into her friends ear.

"Or maybe they noticed some abnormalities on the scans which even more likely because I am me. And I am a lightning rod for bad things, bad things keep happening to me, so why not now too?"

Meredith was already fearing the worst.

On Bailey's and Burke's faces you could not tell whether they are carrying good or bad news. Rather good than bad, Meredith silently hoped. "Dr. Grey ..." But next came Dr. Bailey not, because it was interrupted: "Please tell me that the values have not deteriorated and I finally, finally allowed home?!" Interrogatively, Meredith looked over to the general surgeon and her mentor.

"No, do not worry, Grey. Your values are good and yes, you can go home." Dr. Bailey smiled.

"Oh God, finally." The young surgeon was pleased. "This about time."

"But you have to still preserve that is clear to you, Grey, right?" Dr. Bailey warned the young doctor, knowing that Meredith was the type who will try to fast-track her recovery. "After how many days before I get to work again?" She asked. Now, Dr. Webber turned on, "So after two weeks of rest you can work again. But don't stress yourself, recovery isn't easy and shouldn't be rushed. You've been through a lot lately." Meredith nodded, and then asked, "What about the control echo? Maybe it's wise to do one after what happened … to see whether there are problems with the valve - which I don't hope, really - and the whole residual shunt thingie." Meredith questioned the doctors.

"The first date is tomorrow, and the second and third is then determined by the eventual findings if there is an indication for another diagnostic echo. What I do not expect." Dr. Burke explained and smiled reassuringly. Cristina lowered her head, which not only catched Meredith's eye but Burke was still looking at her nonchalant, then he said: "Get well soon, Grey." His gaze wandered to Cristina. Dr. Bailey and Burke left the room.

"Finally, I get out of here." Meredith was elated.

She grinned happily. That Cristina made laugh. "You'd have to see you." She gasped, giggling. "Stop it, you didn't need to lie here and get yourself bored to death." Meredith groused played and sought a offended expression. Then Derek entered the room. He immediately fell on Meredith's happy grin, and Cristina looked relaxed. "What is going on here?" He asked, confused, looking from Meredith to Cristina. "I can go home." Meredith said, smiling, "you only have to sign the release papers. Then I am freaking free." Derek came up to Meredith and kissed her. She returned the kiss, then Derek said softly, "I'm so glad that you survived." Meredith looked at him in surprise. "What do you mean?" She asked. "I'm so happy and I am happy that you're alive." Meredith wanted to ask something, but Derek kissed her again.

Cristina stayed in the background, she wouldn't want to ruin that special moment to her friend. Suddenly realized this, as her pager bleeped loudly. A loud noise was interrupting the happiness. 911. She has to go. Damned pager call. Cristina had no choice but to leave the room hastily. "Cristina." Meredith called her person asking for, but Cristina had left the room already.

"What's wrong with her?" Meredith asked in astonishment, Derek shrugged his shoulders, as he did not know what was going on with Cristina Yang. Cristina ran down the hall, after a few meters, she stopped.

Her pager beeped another time. Grrr. She hated this thing right now. Normally she didn't hate her pager, especially when she was paged for a cardio case but now, right now her person, Meredith, was being freaking discharged. Why did someone always page her when the time was bad ... She sighed loudly and looked at her pager. It was the ER. Great, they were paging her for sutures. Cristina groaned and then made her way to the ER. Maybe it was a good case. Because, well, it still was a 911 page which means it's a medical emergency. And she *loved* medical emergencies as long as they don't involve her friends. Like Meredith who was her person, not only her best friend but also her person and sister.

Dr. Bailey came back with the discharge papers. Derek signed the discharge papers that Dr. Bailey had brought over. "Okay, I've signed the discharge papers." He said and laid the papers back on the table. Bailey looked over it and then she gazed to Meredith and held the papers to her. "Here, now you just have to sign it." Dr. Bailey told her. Meredith immediately reached for the papers and wrote something down, she was energetic and enthusiastic. To finally get to go home. "Can we go?" Derek Meredith pulled out of her thoughts.

"Um ..." she gave an answer. Derek looked at her anxiously. Meredith rolled her eyes. He was overprotecting and worried, clearly overworried. She was more than fine, she was finally getting out of here. "Is everything all right? Do you want to leave now, Mer? I think we both want out of here as soon as possible." He could not resist asking. Meredith tossed her (hopefully soon to be-) husband an amused look. "Yeah, I'm fine." She sounded convincing. As in really convincing. Heck, she's been ready to get out of here since one week Tyler, the nurse had now brought the wheelchair into the room, because you as a patient you were obliged to use a wheelchair. At least on hospital ground. "Come on, I'll help you." Derek offered. "No, no. Go on, do your own thing. I am fine here, I have to be if I want to go to work as soon as possible. I am way behind the others." Meredith stood up carefully and gently went a few steps. Derek was at her side instantly and propped her, just as a precaution if something should be.

After a few steps Meredith Grey had reached the wheelchair and sat down, immediate relief could be seen on her face, purely facilitated. She breathed in the fresh air when her face hit the sun for the first time in weeks. She took another deep breath and closed her eyes. Finally, no more cold sterile walls ... That was a relief.

She was happy when Derek helped her into the passenger seat and drove off of the hospital parking lot. She leaned her face against the cold glass of the window. They would be home soon. She would be sleeping in her own beds. Suddenly, she felt weariness flooding through her veins and before she knew it she drifted off into a light sleep.

The surgical scar was still not completely healed. Especially it was still quite visible on the chest because of the median sternotomy. The scar was still red and maybe even a little swollen, but over time it become more white once it's fully healed and eventually fade a bit. But it, the scar on the chest, would never fully go away, not entirely. A thin, white line, she would always remember this re -surgery. Sadly, it will never go away. She wished she had never been born with such a defect. Then, much would be easier. On the other hand, the scar and the history, her past, what she had been through, that is a part of her life, her story.

It is a part of her, plain and simple.

* * *

**_A/N: Hey, what do you think? Meredith is being discharged. Which is really good, don't you think?_**

**_For now, I am done torturing Meredith and Derek. They've been through enough. But it won't be the end. They still have many battles to fight. This story is nowhere near an end, just so you know. _**


	26. Chapter 26

**Chapter 26**

* * *

**Number one rule of surgery is limit exposure. Keep your hands clean, your incisions small, and your wounds covered. Number two rule of surgery is when rule number one stops working, try something else. Because sometimes you can't limit exposure, sometimes the injury is so bad you have to cut, and cut big. In surgery, the healing process begins with a cut, an incision, the tearing of flesh. We have to damage the healthy flesh in order to expose the unhealthy. It feels cruel and against common sense, but it works. You risk exposure for the sake of healing, and when it's over, once the incision has been closed, you wait. You wait and hope that your patient will heal. That you haven't in fact, just made everything worse.** I Like You So Much Better When You Are Naked; Meredith Grey

* * *

"Yeah, I'm fine." She sounded convincing. As in really convincing. Heck, she's been ready to get out of here since one week Tyler, the nurse had now brought the wheelchair into the room, because you as a patient you were obliged to use a wheelchair. At least on hospital ground. "Come on, I'll help you." Derek offered. "No, no. Go on, do your own thing. I am fine here, I have to be if I want to go to work as soon as possible. I am way behind the others." Meredith stood up carefully and gently went a few steps. Derek was at her side instantly and propped her, just as a precaution if something should be. After a few steps Meredith Grey had reached the wheelchair and sat down, immediate relief could be seen on her face, purely facilitated. She breathed in the fresh air when her face hit the sun for the first time in weeks. She took another deep breath and closed her eyes. Finally, no more cold sterile walls ... That was a relief. A real relief.

She was happy when Derek helped her into the passenger seat and drove off of the hospital parking lot. She leaned her face against the cold glass of the window. They would be home soon. She would be sleeping in her own bed. With Derek. That was more than she could ask for. She didn't need much to be happy. Just him. Derek. "Are you okay?" Derek looked over to her, just for a moment. "I am okay, really. But watch out, you never know what's coming. Please. The last thing we need is an repeated accident." She shot him a knowing look. Derek knew what she was talking about, so he just turned his gaze and continued to drive. It was evening and it was one of the rare days in Seattle with sunshine. Even if the sun's disappearing right now. But the colors were amazing. Meredith smiled when she watched him in profile. And then the sunset over Seattle ...

Also, there wasn't much traffic. "How about we take the ferry?" Derek's eyes blinked adventurous. "I'd love too, really but I am tired and I shouldn't tired myself out. As much as I want to I have to say no."

Derek nodded in understanding. "We'll take the ferry another time."

The traffic light jumped red and after he looked to the left and right side, to check if there were anything he had to pay attention he did a 'knee jerk reaction' and kissed his gorgeous girlfriend. "What was that? Aren't you supposed to pay ..." She stammered pleasantly surprised ... "... attention? Yes, I am but the light's still red and there's this problem: I can only drive if it's green ..." Derek gave back. Meredith laughed. "And that is an insurmountable obstacle." She countered, still smiling.

Then the traffic light jumped to green and the car accelerated.

This was a good. They were heading home.

They came closer and closer to it every minute. Everything was going to be fine. They were Meredith and Derek and they will be okay. More than okay, they will be extraordinary. Together, he and Meredith will do great things, things she never imagined she actually wanted but with him she wanted it all. That she knew. Meredith inhaled slowly and then exhaled.

Suddenly, she felt weariness flooding through her veins and before she knew it she drifted off into a light sleep.

She didn't see anymore how Derek shortly glanced at the sight of her sleeping figure half lying there in the seat, her head leaning against the headrest. He smiled for a moment before he turned his attention back to what was happening in front of him in the traffic ...

* * *

She woke up as Derek drove into the street where Meredith's house was. "Mer." The caring neurosurgeon said, nudging her shoulder while slowing down their car. "Meredith, wake up." But she never said anything coherently, she just made a grumbling noise and didn't wake up. Apparently, her sleep was that deep. "Meri." He said a bit louder. "Hmmppf, what ..." Meredith mumbled ssleepily, her eyes only half open. "We're almost home, it's time to wake up now. You can sleep in your own bed ..." "Our." Meredith corrected automatically. " ... sleep in our bed which is much more comfortable than a car seat." Derek told her. "We're almost there?" She sounded like a child on christmas, waiting to open the gifts. "Wow, I don't even know how that feels like - being home." She said slowly, looking out of the windows for the last meters. Then he braked and stopped the car ...

"Okay, now we're here."

"Home." Meredith gripped onto Derek's hand tightly once he had stopped the car and let go of the wheel.

"Yes, we are. Feels good, right." For a moment they just sat there.

Meredith was more than relieved to finally be home. Four weeks, four freaking weeks in a bed, in a hospital bed recovering from a major and straining heart procedure were more than enough. Staying four weeks in the hospital as a patient was definitely not her favourite thing. She hated being the patient. To be on the other side of the patient - doctor / doctor - patient situation ... It was hard on her. She went emotionally through hell. And it hadn't been just her. It had been Derek too. Cristina who was the one who made all judgment calls whenever she needed to make them - with the help of Derek. Bailey and all the others tat cared about her. These last few weeks have been hard on them. But it's over now and hopefully the future will bring joy and more memorable moments with the people she loved, the people that are her family ...

When they were home Derek parked the car next to the house. "Should I help you or ..." Derek asked. He motioned to her chest. "It's not like I am going to break down any minute Derek. I am not that fragile. Okay, my chest hurts and that sucks right now but without that surgery I would have been dead in a few months or even earlier. I know it's sucks, believe me I do but we'll get through this. That little pain won't stop me." Meredith said, attempting to smile but it was only a weird grimace. She unhooked her seat belt and slowly sat on the edge of the seat and then, she was standing up. A pained expression covered her face but she was too 'Meredith' - like to say something.

She took a few unsecure steps towards the frontdoor, with Derek glancing at her proudly. She never even stopped even if her incision was hurting she didn't show it. This was his Meredith. Unbelievably strong. "I made it." Meredith said a bit tired as she reached the frontdoor. "Without help." "Here, catch." Derek throwed the keys over to her and Meredith did catch them and unlocked the door. "I'm on my way, I'll be there. Just make yourself comfortable." Derek called back. He unloaded a heavy suitcase with Meredith's things she had needed for her hospital stay. Due to her heart surgery.

"Uff, that's quite heavy." He mumbled to himself as he made his way to the frontdoor. "Get over yourself." Meredith called back, she was already in the kitchen waiting for Derek.

"You are overdramatizing things." She called back, rolling her eyes.

Knowing that Derek wouldn't be able to see that.

But that was okay too.

"You might be right that way." Came as a reply. Meredith snorted. "See?" Then she heard a thump and she assumed Derek had closed the frontdoor - which he had - and now he entered the kitchen.

"So ..." He said, looking around. "What are we gonna do with our newfound freedom?"

"You're funny." Meredith giggled in response.

Derek was carrying her up the stairs to the bedroom. They were alone in the house. "Derek." She exclaimed surprised. She hadn't expected he would do that. "Let me down, I am too ..." Meredith didn't finish the sentence. They were almost upstairs. She buried her head in his neck, hoping he wouldn't stumble across a step. And he didn't. "What? No, you're not to heavy. You're a lightweight, there's no way I can't carry you, so stop protesting." He said. "But your back." Meredith replied softly. "MY back's fine. No problem." He shrugged it off like it was nothing.

"And you're supposed to take it easy. Rest. Watching all kind of idiotic movies - kind of rest." He added as he entered their bedroom. He sat down on the edge of the bed, Meredith still snuggled into his arms. "We're home." She mumbled into his chest, her words were muffled. "We are." Derek replied, smirking. "Can you believe it? I mean can you actually believe we're actually home after so many weeks in some cold, sterile environment?" She looked up to him as she said these words.

"After a that long time we're finally back where we belong. What a shame that we can't celebrate it properly ..."

"Oh, you mean ..." Derek kissed her on the top of her head.

Meredith nodded.

"We'll have to make that up as soon as we can." Derek offered slightly devilish, having some particular activity in mind. "Mm, I think I am on board with that ... Yes, definitely on board. I look forward to it ..." Meredith replied, her eyes twinkled. "But we can't exactly do it now ..." Silence for a moment. Both of them were falling silent, Derek grasped Meredith's hand. "But I want to." She added quietly.

"Me too." Derek answered. Meredith looked at him, directly into his blue dreamy - ish eyes. She could drown in those eyes, she believed. Then Derek continued: "But being here with you, is almost as good as shower sex. I mean, just being here with you ..." He looked into nowhere, "... is enough right now. I cannot imagine what life would be like without you."

"Lonely, I guess."

"Yeah, lonely it would be for sure ... among other things I won't say, because right now in this moment I am just glad for every moment I have with you. I know how fast that can change ... It's a gift, a precious gift ... We shouldn't squander any moment because you don't know what can happen ..." He trailed off, referring to certain happenings that happened not far in the past ... "You're starting to get all warm and full of secret feelings ... Mcdreamish ... I love you too." Derek said, smiling when he saw Meredith looking up to him. She rolled up him, even if her chest protested a bit. Her face scrunched a bit but soon everything was back to normal. "I am happy. Another week in the hospital and I would have gone crazy. Seriously." Meredith made him laugh with one single comment coming from her.

Derek empathized with Meredith and her feelings, four weeks in the hospital - as a patient lying on the surgical ward, recovering from a surgical procedure, and not as a doctor - were more than enough. Not only for the patient, as well for the relatives. Even if he hadn't been there as a patient (for the most part, when ignoring the bus crashing against some car that somehow happened to be his car - thing and as a result of that he ended up in the ER of Seattle Grace Hospital. Leaving Meredith freaked out, but where he luckily hasn't sustained any life-threatening injuries. Besides of a mild to moderate concussion, which was almost nothing. Most of the symptoms were gone after a week after it had happened.

"I'm glad you're here. With me." He said quietly, interrupting the comfortable silence, supported his chin on her head, Meredith turned so that she could look at him.

"Me too." She simply replied.

She yawned soon after that, Derek eyed her. She seemed tired. "Are you tired?" He asked, gently running his hand over her side.

"Maybe a bit." She replied.

"It's okay to be. Yor body needs to regain its strength back, sleep is important right now." Derek told her.

"So I've heard." Meredith replied. "Can you switch off the lights and just hold me?" She asked in a sweet voice. "Sure, I can. Wait." He said, jumping up, then he came back. Lying down on the bed. His body next to hers and he holds onto her tightly. "What if I hurt you?" He asked, sounding worried. "You won't. You could never hurt me." Meredith's words were reassuringly and soon he just relaxed. "Just come lie down next to me ..." She repeated quietly.

"Do you want to sleep?" He suddenly asked into the dark.

Silence.

"No." Pause. Then came from her: "Do you?"

"Not really." Meredith snuggled deeply into his arms.

"God, this is perfect." Meredith suddenly said. "I've had no idea how much I missed this until now."

"What did you miss ..." Derek asked back dumbfounded. "Us, you idiot. In a hospital isn't really much privacy. Especially as a patient in ICU or stepdown. You get poked and prodded - they use you as a pincushion." She whined a bit. Derek laughted and earned a smack on the arm. "Oh, don't give me the mopey face." He said as he saw Meredith sulking face expression. "Why not?" She asked back. "It doesn't suit you, that's all. Even though you still look breathtakingly beautiful ..."

"It's dark in here, how can you say that if you don't see me?" Meredith wanted to know. The 'McCouple' was still up talking about some things. "Doesn't matter, you're still you. And you are amazing." He replied. "I honestly doubt that, but it's flattering." "No, you really are, I mean it." Derek said, obviously trying to convince her. "You do."

"I do. If I didn't I would not be saying something like that." Derek Shepherd replied into the dark. He swooped her into his arms so that their bodies came nearer. "I love you, Der." Her voice was barely audible.

"You're the best thing that's ever happened to me. You are my oxygen." She confessed with a small voice. "Well, same goes for me too." He replied with a smirk. Which she can't see in the dark but ... "

"Ouch." Derek replied.

For a while, nobody said anything. Then, suddenly Meredith shifted under her blankets and she interrupted the silence with asking his name: "Derek. Der, are you awake?"

"Hmpf ..." He grumbled something into the pillows.

"Can I ... can I ask you a question?"

Her voice sounded slightly unsure. "Sure, shoot." Meredith inhaled audibly before she asked that question. "Derek. Please don't run again." She just said before asking the real question.

"I won't. I promise."

"Good." Pause. "What happened to your ... father? Are you ready to talk?"

Derek stiffened for a moment which caused Meredith to hold her breath. "I mean, you don't ... if you feel uncomfortable answering it you don't have to ..." She rambled, worried that she had destroyed everything. Derek felt Meredith's nervousness, that she had done the same thing as the first time ...

"Mer." He said, his voice a bit shaken.

"It's okay." He took a breath. "It's just so hard to talk about it. And it still hurts like hell-"

Meredith stared at him, although he couldn't see that in the dark. She wondered what had happened. "Take all the time you need." She told him. "It happened when I was ten or eleven, around that. My youngest sister Amy, she was only five or six years old. She doesn't really remember him."

"Your _youngest_ sister? There is more than one?" Meredith exclaimed, shocked. Derek cleared his throat, a bit relieved that Meredith obviously had forgotten their previous topic. "I have four sisters ... Amelia, Liz, Nancy and Kathleen. One is worse than the other when it comes to my relationships ..." Derek knew that she won't take this information lightly. "So, once they meet me, they'll hate me instantly, is that what we're saying?" Her voice quivered.

"No. I don't think they will hate you. They don't know how a great person you are, but they will once they get to know you. You don't have to meet them anytime soon, if that's a problem with you." Meredith didn't reply. Derek had four sisters. That's a lot. But she had two sisters herself, so ... But she never got to know them. She never grew up with them, or had a real family. Derek has a family. "I'll be ready to meet them someday from now but not right now." She said.

"I am probably pretty bad at the whole family thing, you know. I've never had anything like that. Sisters. I have never had that. I know there's Lexie and there's Molly, my two half - sisters I've never even met." She was rambling again.

"Okay. I was ten when it ..." Derek stopped when he saw Meredith's embarrassed expression.

"What's going on?" He asked.

"Sorry, for interrupting you and for being so insensitive, for being so self focused." She bit onto her lower lip.

"It's okay, Meredith. It's really okay."

Meredith still wasn't so sure about that but it was better to just shut up and listen to him.

Derek cleared his throat before he started speaking. His voice sounded hoarse and was filled with strong emotion and pain. That she noticed when he started telling her about that day ...

"Two men came into the little store our father had owned, they had guns and they wanted money ..." Disbelievingly, he shook his head as if he couldn't believe that it really had happened.

"What happened then?" Meredith asked gently, grasping his hand for support.

"And then the two guys came in, we could hear them talking but we weren't paying attention until dad yelled. They had already pulled the gun, and they had already taken the money… And now they wanted the watch that mom gave him for their first anniversary. He wouldn't give it up ..." Derek shuddered at the memory on this day - the day, everything had changed completely. The day his father had been murdered by two men with guns.

Meredith stayed quiet. It was better not to say anthing, to just let him talk.

She just held his hand for support.

"They just shot him, Mer." He whispered as he choked back a sob. She pressed his hand tightly. "Ssh, it's okay to let it out." "It's been so many years since it had happened ... but it still hurts." He told her, suddenly he looked vulnerable. "I tried to save him after they were gone but I couldn't - he bled out while we were waiting for an ambulance. It was horrible. The blood, it was everywhere. On my clothes, my hands ..." He said, obviously shaken up when he recalled these memories.

Meredith looked at him with big eyes. "I don't really know what to say. You must have been so scared. I ... I am sorry you had to go through that. You really love him, don't you? Before he died, before he got shot, was he a good dad?" She asked, trying to not get emotional. But this story was unbelievably sad and horrific. On one single day two men had destroyed one family, just ripped them apart for money and a watch. What's wrong with people.

"He was the best dad you could possibly wish for."

"Good." Was her only reply. She swallowed hardly. Derek tried to distract himself from the memories,

Then there was silence. They just laid there, feeling the warmth coming from both of their bodies. Eventually in the next minutes both of them fell asleep. "Night." Someone mumbled, followed by some inrecognizeable noise. Soundly, without nightmares or anything that could cause trouble at night ... They now knew the benefits of sleeping in their own bed. They knew that that shouldn't be taken for granted ...

* * *

In the next morning, Derek was the first to be awake. The sun had woken him up, yes, sun. Sometimes, there is sunny weather in Seattle. And two in a row, that's a welcomed surprise. Meredith was still sleeping soundly, she snored a bit. He smiled when he saw her lying next to him. He stood up, careful not to make any noise. He didn't want to wake up Meredith. Stealing her the much-needed sleep. She was still asleep, but she started turning under the covers. "Don't make up." He whispered. "I'll be right back." As if she had heard him, she stopped turning. Derek smiled and went downstairs to prepare breakfast for Meredith and him in bed. It was meant to be a surprise for her.

After ten minutes he was done preparing breakfast and took the tray with the food to take it upstairs to their bedroom.

On his way he met Izzie, who was eyeing the tray. "Breakfast for two?" She asked. "For Mer?"

"Certainly." He answered. "Okay, I gotta go, my shift starts soonish and I don't want to be late. Bye, Shepherd." She said before she entered the kitchen herself to percolate coffee. "When you want coffee, there is still a rest of it in the stove. If you want it." He called after Meredith's roommate as he went up the stairs.

"Thanks, I found it." Izzie called back.

Soon he heard footsteps running towards, what he presumed, was the frontdoor and then the frontdoor was closed with a huge thump. Hopefully it hadn't waken up Meredith. So he continued his way to their bed, set the try on his nightstand and gently squeezed Meredith's shoulder.

"Hey, sleepyhead. Wake up." He softly murmured.

"'m tired, let me sleep." Came back from under the covers, only Meredith's hair looked out. Derek hoped that they hadn't stayed up to long yesterday, that they haven't overdone it. "Mer, breakfast is ready." He bribed. Now, within seconds, Meredith's head looked out from under the covers. "Breakfast, where?" Now he could tell that she was hungry. Her eating skills were one of the things that keep amazing him. "Here." He said, pointing to the full tray.

"You did that? Wow, Derek, ... that's ..." She sat up.

"We don't even have to leave the bed." "I know." He answered, smirking. "I knew you would like spending the day in bed with your boyfriend, including having breakfast there." "Come here."

She outstretched her arms to him. "Come here, McDreamy." Derek looked at her in shook.

"You didn't just call me McDreamy, did you?" He asked flabbergasted. "I did." Meredith replied, giggling. "You will pay for that." He replied laughing as he let himself fall on the bed and embraced her in his arms. "So that is me paying for it." Meredith stated. "I like it." Derek tried to hold back a laughter. This situation was hilarious.

He planted a kiss on her cheek.

"Let's eat." He said.

Meredith nodded and kissed him back. "So, now we can eat." She said.

Her eyes were fixated on the food on the tray. "You are hungry, aren't you?" He asked, as he ran his hand over her arm. "Damn right you are. I am really. I didn't think I was when you woke me up. But right now I am." In this moment, her stomach growled loudly. "See, I am hungry." She told him.

"Let's see if we can do something about that." Derek replied, as he reached for the tray.

* * *

Two hours later, they were still lying on their beds, doing nothing except breathing, talking and pretty much staring at the wall all the time. "What are we going to do with our free time? I am bored, can't we do something more interesting than just lying around here and doing pretty much nothing? We have far enough free time. And we can't even think of something we want to do. That's funny." Meredith whined. Derek turned his head to look at her.

"Just rest." He simply replied.

"It's all I did the last five weeks and I am for sure as hell not going to do this the next two weeks because then, I am psych case." Meredith complained. "Okay, now you're exaggerating the whole thing. Think of it as some kind of vacation." Derek told her, quite amused by what he saw. "Yes, a vacation without being able to have sex with my boyfriend."

She made a face when she saw DereK was holding back a laughter.

"But I can't have that, and that's making me crazy."

"That's perfectly clear to me." Derek answered. "You don't do a good job at hiding it." Meredith scoffed. "Because I don't want to hide it. I want to have sex. I need it after more than five weeks of abstinence. But I can't because my freakin' ribs need to heal." Damn it, she is in a mood, he thought to himself.

"We'll have lots of that once your ribs have fully healed."

"That only means more waiting." Meredith grumbled, she was acting way to skittish for Derek's liking. "Right now, I hate the fact that I have had open heart surgery because it keeps me from doing the things I love." She vented to herself, Derek only listened with half an ear. "So since I don't have to work for two more weeks ..." Meredith didn't react, she fell silent after she had finished ranting about the things that were unfair to her. "We could do something together." He suggested.

"Maybe in the second week." He added, hoping there was some kind of reacting coming from Meredith.

But there wasn't coming anything from her.

"Meredith." He said her name to get her attention. She had spaced out. She was someplace different with her thoughts. Meredith never even looked at him, she seemed somewhat agitated. Maybe she was experiencing pain. Derek remembered what one of his professors had once said about pain management after a total sternotomy. That proper pain management was a must. Because the patient's ribs have been pulled back, being forced to stay pulled back to get a clear view on the surgical area, that they divide the sternum - all that causes pain then. Derek noticed that after she hasn't really made a movement since he had a question or said something. "Are you even listening to me?" Meredith was snapped back into reality. "What did you say? Yes, I am listening." She said, Derek tried to make eye contact with her. "No, you're not. Meredith, what is going on?" He asked finally. "I am fine."

"No, you're not. Your face is telling me that you're are not feeling fine. Damn it, Derek really could read her like a book. "So what's going on with you? Does your midline incision hurt? Do you want some pain meds? They gave you a prescription for oral pain medication before they released you. Should I get you some pain meds? I can make a run to the pharmacy if you need me too. Please, Mer, tell me how I can help you." He pleased.

Derek glanced at Meredith's face, trying to figure out whether she was in pain or not.

"Derek." Her voice sounded really small. "What is it, Mer?" He asked back gently. "I may take you up on that offer with the pharmacy thing." Her voice sounded strained and thick as she said those words. "Oh, Mer, why didn't you say anything?" He questioned her as he ran his hands over her side. "I didn't want to disturb you with my problems. I just need some oral pain meds, that's all. The pain can be controlled with that."

"You sure?"

"Positive." Meredith replied, wiping an unruly streak from her face.

"Is it your incision?" Derek Shepherd asked worriedly. "Should I take a look at it? See, if it's infected. You never know what causes the pain. Should I take a look at it? You know, I as world renowned neurosurgeon?" He wanted to be sure it was nothing too serious. "No, Derek it's just healing pain. I am okay. Although the requested pain meds would be nice." "I am on my way out." Derek told her, kissing her softly on the cheek before he left the room. "You sure you're okay? Besides the pain I mean?" He asked slowly. Meredith nodded.

"I am. See you later, Derek."

"Love ya, Mer. I'll be back with your pain meds in no time. Stay put while I am gone, don't do anything risky." He advised her, it was meant to be helpful and caring but for Meredith is the hovering thing annoying - at least right now. "I won't, okay?" She said, rolling her eyes as she sat upright in her bed.

She didn't want to pick up a fight with Derek.

When Derek came back thirty minutes later with her pain meds, she was reading in some neurosurgery magazine Derek had subscribed and that was being sent to her home monthly. She looked up when she heard his footsteps. She saw him leaning against the doorframe and smiling at her with his gorgeous McDreamy smile. "I see you've found yourself something to do." He chuckled slightly. "What are you reading? _Neurosurgery Today_?" He asked, while pointing to the cover. He tried to see what article she was reading. "Do you like neuro or do you just like the neuro god?" He asked her playfully.

"Derek." She scolded him. "What the hell was that?" She asked, being taken aghast. "Please." He made a mopey face to caused her to laugh and finally to answer his question. "I like neurosurgery and not just the neuro god. But him I love too. He is so handsome and he's really good in bed. But he has that big ego and thinks he is god, well - he has god complexes sometimes ... But he's my hero and I really love him. Since I know he just brought me my very much needed pain meds." Derek ignored the last comment wisely. He smiled at her.

"What issue is it?"

"Issue July 7/2008. Pretty interesting if you ask me." She giggled but winced when she felt the impact that the movement had on her ribs. "Damn it, that hurts." She squinted with her eyes in response. "Are you ..." He didn't finish the sentence. "I am fine." The ribs had finally stopped hurting that much. It got better, she just needed to adjust her breathing, then everything would be okay.

She smiled at him.

"Makes me miss surgery a hell lot more."

"Nice to see that you calmed down. Do you want to take one or ..." He held up the package with the medication. "Give that to me." She told him laughing. "What, you need 'em?" He grinned. "Why haven't about that?" He mocked her a bit when she looked at him with those puppydog eyes, trying to make him do what she wanted. "Please. I'll grumble never again." She bribed him. Her chest really was hurting. She'd just blocked it out for the most time for making the pain bearable.

Then he suddenly noticed the pained expression and somewhat pale complexion and he worried even more.

"Here." He said, handing her the meds. "Is the pain really that bad?" He asked concerned. "Although my pain threshold is quite high when it comes to medical things. Although that doesn't seem to be working with having your chest cut open, your sternum divided in two and your ribs pulled back in order to get to your freakin' heart to correct it. But wait, it's still beating - so what do they do? They stop my heart and put me on bypass ..." She trailed off as she remembered the gory details of her heart surgery. She hadn't seen it though but she had seen the procedure not long ago on one of her patients.

Meredith looked at him before she nodded.

"I'm sorry for mocking you. If I knew it was that bad I wouldn't have been doing that." Derek apologized. "I'll get you a glas of water." With that he left the room. Before she knew it, he was back with the very much needed water in a glas. Holding it in his hands cautiously so that it wouldn't splutter everywhere. "Thanks." Meredith said and took the glas. Now she really felt the need to drink something. Something like water. So that she wouldn't get dehydrated. Because that wouldn't do anything good, especially not with her current condition.

She hadn't even realized that she needed water, that she actually felt thirsty. But Meredith did feel in fact thirsty, but her body hadn't shown it until now. Meredith took a sip, after she swallowed the pill. And then she emptied the whole glas with one big sip. Derek watched her doing that. "Wow. You really must have been thirsty." He didn't say that in a seductive way ... but she almost wished he did.

"You have no idea." Meredith replied chuckling.

"Here." He suddenly said, revealing something he had never shown before. "It's for you." He said. It was wrapped in something. "It's just chocolate, I thought you could use some candy ..." He sounded abashed although there was nothing he should be abashed for ...

Meredith's eyes lit up when she saw the chocolate. "Oh, Derek. That's so sweet from you. It's exactly what I need."

She opened it and took a piece. "Yummy, tastes great. You want too?" She asked. After he took some piece of chocolate, he turned to her. "Is it getting better." He asked, refering to her pain.

Meredith cocked her head and nodded after a short self assessment of her pain level. "It is, actually. I am already feeling its effect. The pain's starting to subside. Slowly but it does. Thank you for getting me these pain meds. You have no idea how much I thank you." "You can repay me later by *makeup - sex*, although it isn't really makeup - sex since we haven't been having a falling out ... Get that, I am starting to ramble too. Your rambling has an effect on me too." Derek chuckled when he said this. "I love you, Mer. I want you to know and remember that." He planted a kiss on her cheek. Meredith closed her eyes and felt his arms embrace her when he laid down as well. "I love you too, Der."

* * *

_**A/N: Hey, thanks for reading, guys ... **_

_**This is just a short (long) chapter with a bit MerDer fluff. We all need it dearly, I think ... with everything that's going on in the 'real' Grey's Anatomy. Meredith and Derek on two different coasts. Them fighting about the job offer and with Derek leaving for Washington D. C. Here are some happier times for our favourite couple. I know it's short, all the previous chapters were way longer but still, next post is probably Tuesday or Thursday. R&amp;R please ... I'd really like to know what you think about my writing. Have a nice weekend.  
**_


	27. Chapter 27

**Chapter 27**

* * *

**If you're a normal person, one of the few things you can count on in life is death. But if you're a surgeon, even that comfort is taken away from you. Surgeons cheat death. We prolong it, we deny it. We stand and defiantly give death the finger. We're born, we live, we die... sometimes not necessarily in that order. We put things to rest, only to have them rise up again. So if death is not the end, what can we count on anymore? Because you sure can't count on anything in life. Life is the most fragile, unstable, unpredictable thing there is. In fact, theres only one thing about life we can be sure of. It ain't over, till it's over. **Meredith Grey; Rise Up

* * *

Today, Meredith had the follow-up. But she didn't want to get up. Derek already was up and tried to make his girlfriend do the same. She should get up now, she needed too. If she didn't want to be late. "C'mon Mer, we have to go." Derek urged her. "Why do we have to go?" Meredith asked. "Your appointment with Burke to make sure everything's just the way it's supposed to be after surgery. Now, get out of bed. We're gonna be late, so we'll have hurry in order not to be late. I mean he saved your life, the least you can do is being punctual for your follow-up." "Grrr. I am sick of doctor's appointments. I just wanna sleep, nothing more." Meredith grumbled into her pillow, her head almost disappearing under the cover. Derek tried to stay calm and fought off the urge to shake her shoulder and telling her to get her ass out of bed and moving. No, he didn't do that. After all, she was still his Meredith who he loved more than anything. Derek Shepherd softly laid a hand on her shoulder and nudged her. Meredith didn't budge. Derek looked at his watch. They were going to be late if Meredith keeps doing that. "Mer. Get up." He said a bit louder. Still nothing. "Let me sleep." Suddenly her voice rose a bit, he could hear her just fine.

"You can sleep after the appointment. Let's go, Burke is waiting for us." Finally, Meredith got up and rushed to get herself ready to go. During the drive to the hospital neither of them were saying a word at first. Meredith shifted uncomfortably on her seat. Although she wouldn't admit it, because then Derek would be right, she was nervous. Immensely nervous. Getting really bad news - kind of nervous. Meredith looked out of the window as Derek parked the car in Seattle Grace's parking lot. "Now we see how much time that surgery bought me." Meredith mumbled, her words barely audible and _**very **_pessimistic about the whole thing. Derek noticed her uneasiness when they were about to be led to an exam room where Burke could do the ultrasound to be sure everything's just like it's supposed to be.

Before Derek and Meredith entered the exam room, they met Bailey who carried a stack of patient files and lab reports. When she saw Meredith and Derek roaming in the halls of Seattle Grace, she called over to them: "Grey, Shepherd." Both of them turned and waited for Bailey to catch up with them. "How's it going at home, Grey?" She adressed her intern. "I'm fine, I really am. He wouldn't let me sleep though because of the follow-up with Burke." She told her resident. Bailey frowned. When Grey told her she was fine that's always a reason to be alarmed. "You sure you okay? Be honest." She waited for her intern to answer. She had no reason to worry. Meredith looked good, she wasn't nearly as pale as she was before the surgery and everything that had happened. Meredith inhaled and then glanced over to her caring resident, who had shown a soft side when they discovered that Grey needed open heart surgery.

"I'm good. Tired but good. Pacer's doing its job, incision hurts which is to be expected but can be controlled with oral pain meds and yes, I am good. I am bored out of my mind but medically, I am just fine." Meredith answered, which resulted in rambling. "Good. I hope you're soon ready to come back to work. We miss you here." "My colleagues probably only because they have to cover my shifts, besides Cristina and Alex." Meredith's last sentence was spoken in a barely audible voice. "Okay, I have to go. I hope everything goes well in there for you, Grey." Dr. Miranda Bailey gave her intern an reassuring smile.

"Yeah, me too." Meredith replied.

Derek waited for her to come. "Okay, Grey. I have to go. I have a patient prepped and ready waiting in the OR for me to start."

Meredith lit up as soon as she heard the word surgery. "Can I please scrub in?"

Even though both of them knew it was a joke, it had something. Despair.

"Grey." Bailey was taken aback (which happens not very often, but sometimes there are even situations that make Bailey speechless and that was one of those). "That wasn't a real question, was it, Grey?" The general surgeon wanted to know. "Please tell that that wasn't a serious question because then I starting to question whether ..." Meredith grinned. It was funny watching Bailey freak out, especially when she couldn't do anything to punish her since she was here as a patient and not as an intern. Even if Meredith rather would be here as an intern.

"No. I wish it were." Meredith offered her as an answer.

"We'll talk about that in two weeks, Grey."

"Fine."

"Ok, I gotta run. Patient's prepped and ready. See ya."

She really wanted to be back in the OR. "I want to, I miss surgery." She mumbled almost inaudibly. But Dr. Bailey was already on her way to the OR. Suddenly, she felt someone next to her, breathing on her neck. It was Derek who knew that she wanted to back and he couldn't, he understood that she wanted nothing more than to be back, scrubbing in on back-to-back surgeries. Preferable neuro cases.

"It's okay, Mer." He soothed her. "It's only one and a half week before you'll back, we'll back." He said. "I know. But I ... miss being in the OR." She said, looking up to him. Their conversation was interrupted by a nurse who told them that exam room 1954 was ready and prepped for them and that Dr. Burke will be here any minute.

"I'll see if I can find Cristina after this appointment, if that's okay." Meredith said.

Derek only nodded, he felt that Meredith needed time with Cristina to feel at least a bit like herself. Like the woman they had known before the whole cardio thing had happened.

Then she and Derek were led into an exam room, soon after that Burke entered it. "Grey, Shepherd. Nice to see you. I hope everything's going as it should." He said. "I am fine. I really am. I feel much better than before the surgery." Meredith offered him as an answer. "Can you be a bit more informative if possible?" He asked her to be more detailed. Meredith nodded. "I can. I am still tired, but that's okay. Pacer's doing its job which is great because now I have more energy and well, I can to things without getting dizzy. That's a relief. It really is." She told him honestly.

"That's good. How is your pain you're feeling from your incision? Is it manageable or do you feel like its not?" Dr. Burke wanted to know.

"It is there, yes but can be controlled with oral pain meds. So, yes, I am good. Medically at least. When can I come back?" She really wanted to be back. "Don't know yet, Grey. We have to see what the results say." He answered, not wanting to give her false hope. "Okay, let's do the echocardiography and the ECG so we can see where we at." He admitted and squirted the gel on Meredith's chest. She didn't flinch when the cold gel touched her skin.

Meredith looked at the same monitor as he did and just hoped he wouldn't find anything pathological that meant intervention - again. When Dr. Burke saw Meredith looking at the screen, he turned it so that she wouldn't see what the images showed. Derek frowned when he lost view of the pictures. He wanted to be sure Meredith was or would be alright. He wanted to see it for himself. Meredith leaned back, there was nothing she could do anyways so what. Derek tried to catch a glimpse of what was going on but he didn't was very successful. Also, he trusted Burke to do a good assessment, he is the bigger influence when it comes to hearts and echocardiographies. His opinion would be sub-par to his anyways. He just needed have a little faith in things that's all. If it were a brain scan, then he would be the one who is the bigger influence, sure.

But right now, it was not him.

It was Burke who was pressing a wand against Meredith's chest to get a clear view of what was going on in there. Derek was focused on his face expressions to see if it was going to be good or bad news. To get a reading of what he thinks when he sees her heart. Then he interrupted the awkward silence: "It's not enlarged, is it?" He demanded to know, although his voice was quiet. Dr. Burke shook his head. "It's not. Thankfully, it's not. It seems like your new aortic valve is working the way it should be. That's good." Meredith breathed a sign of relief she didn't knew she was holding.

Derek pressed her hand and whispered: "That's a good thing, Mer."

She didn't react. "It means we can live our lifes for once without worrying about your heart."

Meredith finally glanced at him. "I know." She replied.

"But that doesn't mean that it stays that way."

"Why can't be positive for once." Derek said, his voice was now slightly annoyed.

"Fine." Meredith sat up and wiped off the gel of her chest. She scrunched her nose when she looked down her chest, seeing the scar. The huge scar with staples in it. She didn't want to imagine the pain they will be removed. That's gonna hurt like hell. "I'll be positive." Meredith replied ironically, as Derek tossed her her shirt. She was grateful for that and started pulling it over her head. "That's not a positive attitude." Derek alluded. "Well, you should know." Was the only answer he got from Meredith. "But it's a good thing that my echo's come back clear." She relented.

"See. Look at the bright side." Derek laughed.

"I am not bright and shiny, I am dark and twisty." Meredith argued back.

After they also did the electrocardiogram, Dr. Burke wanted to discuss the results of the tests they have done to make sure Meredith will be okay. "Grey." He cleared his throat before he continued: "Your cardiac echo looks good, but I recommend you take it easy for the next days, no heavy lifting until the pacemaker wires have attached themselves onto your vessels. If you lift heavy things, your at risk of detaching them and that wouldn't cause anything good. Take short walks every day but don't overdo it. I'll see you back here in one week." Dr. Preston Burke told them.

"So, everything's good." Meredith wanted to make sure. "Yes, your heart looks good, there is no fluid around it, her valves are both working, so yes, you're good." Dr. Burke smiled as he told his intern the great news. "That's ... great. Derek, have you heard him?" She gushed enthusiatically. Derek frowned. "You didn't sound like that a few minutes ago." Derek replied.

"I know." Meredith couldn't think of another answer.

"Am I free to go?" She then asked.

Dr. Burke nodded.

"You are, Grey." Meredith smiled and hopped off of the gurney.

"Bye." She before she disappeared. Derek followed her more slowly. He shook hands with Burke before he left the exam room. "Thank you for everything." He said, refering to doing Meredith's surgery and with that saving her life. "It's my job." He answered, although it was a hell lot different since Meredith Grey was Cristina's best friend and her person. But he didn't say that. He didn't have too. "It's not just that." Derek replied. "Anyway, we'll see eachother when we come back to work."

* * *

Meredith Grey seeked for Cristina Yang. But somehow her person was nowhere to find. She was glad that the test results were declared as no abnormality detected [abbr_.:_ NAD] but she really needed to find her person to have some freak-out time with her. Some much needed freak-out time. "Damn it, Cristina, where the hell are you." She muttered under her breath as she wandered through the halls of this hospital. She had checked the tunnels, a place that had been claimed theirs, the ORs to check if she scrubbed in on some fancy surgery. But she didn't, Meredith had checked the OR board and the galleries ... She still hadn't checked the pit or the cafeteria.

Cafeteria. Maybe Cristina was there. If she wasn't there, maybe she was handling the pit. Meredith would look there when she isn't in the cafeteria. On her way to the cafeteria she met Alex Karev. "Hey, Alex." She adressed him. "Meredith. What are you doing here?" He responded, his eyes scanned her. "You aren't supposed to be back for another one and a half week." Meredith rolled her eyes.

"I am not back yet." She answered.

"I was here for my follow-up with Burke. He did my echo."

"And ..." Alex looked at her, waiting for her to tell how the results were. "And no, he hasn't cleared me for work yet. That has to wait for a little while."

"Are you okay? I mean, you look like you are ..." He didn't finish his sentence.

"Well, my cardiac echo came back clear and so did my electrocardiogram, which means my pacer's working - which is, if you ask me, a huge relief." Meredith told him. "That's good. When do you come back to work. I mean, aren't you missing surgery. And I don't mean it in 'you have to have surgery' but in you get to scrub in. Isn't it clear which one every surgeon would prefer?" Meredith chuckled. "Yeah, of course I miss surgery. But what a difference will it do if I come back to back now or in one and a half week. There isn't so much time in between." Meredith glanced over her shoulder.

"Have you seen Cristina somewhere?" Meredith questioned him.

"Cafeteria, I think." He answered. "But I can be wrong."

"Are there any interesting cases." Meredith couldn't not ask. She just had to. It was a reflex she couldn't control. She suffered from a lack of surgeries. "You bet there are." Alex laughed. "I am scrubbing on pneumectomy with Burke which is ..." He didn't finish it, Meredith did that for him. "... seriously fucked up and totally unfair." "Foe you, yes but not for me. For me, it's heaven. Okay, seriously that sounded like Izzie." He said. Meredith nodded slightly, beginning to feel the exhaustion setting in. "Okay, Alex, I am just gonna go and find Cristina." She said before she headed in the opposite direction.

* * *

When Meredith had the grand idea to check the the radiology rooms she finally found Cristina there staring at some x - ray of some unnamed patient of hers. "Cristina. Here you are. I was looking for you." Meredith exclaimed as soon as she saw the black curly locks of Cristina Yang who turned within seconds when she heard the voice of her best friend. "Mer?" Cristina asked, obviously very surprised to see her person standing there.

"What are you ... you are not back, are you?" She asked with big eyes.

"Calm down, Cris, I am not. I've just had the echo, Derek is somewhere around, probably with Mark. But anyway, what are you on?" She pointed to the x - rays, now seeing that is wasn't just one x - ray, there were also other images including one CT and MRI. Meredith came nearer to glance at the images.

"I am on peds, Mer. Pediatrics. Me, Cristina Yang." Cristina offered her as an answer.

Meredith almost choked when she heard that because it was so damn unimaginable for her. Her person was on peds, working with happy, perky, shiny and very bubbly attending who was nothing more than Dr. Arizona Robbins, pediatric surgeon at Seattle Grace Hospital.

"Did you already eat some small, innocent children?" Meredith asked, half-joking.

Cristina gets what she means.

"I worked on an baby with necrotizing enterocolitis and logged therefore some interesting hours in the OR. Which was great by the way ... but another baby, Arizona had me change the diapers I think it was some kind of punishment, and it peed on me ..." Now Meredith broke down laughing. And the best part was that her chest didn't hurt that much, only a little.

"The baby knows that I don't like being there and promptly, as if it where revenge, it peed on me." She repeated stunned.

"Maybe the baby feels it." Meredith said. "I already said that, don't have to say it another time. But I get that pediatrics isn't a very good specialty for me." Cristina Yang told her. "I mean, I can't work with babies, I don't understand them, what they need when they start to cry ..." Meredith nodded. "I know some people freaks it out." She replied. "What are wie looking at?" She questioned her person. It were someone's bowels, so much was clear and then Meredith saw it: "That looks like ..."

"... like an intestinal malrotation." Cristina cut her off.

The abodominal radiographs showed right sided jejunal markings and absence of stool filled colon in right lower quadrant. Also the "Double-Bubble" - phenomenon could be seen on the plain films of the patient. In the absence of midgut volvulus they showed these signs, but these images are neither specific nor sensitive. But it was clear: It wasn't just a malrotation, it was more than that. They both knew it. Both interns stared at the image.

"Poor baby." Meredith said, already imagining what the baby must go through. She knows what that means - being born with a birth defect. It's hart, so so damn hard sometimes.

"It's an intestinal malrotation." Cristina said. "Arizona had me do the sonography on the baby and it showed an inversion in the SMA/SMV relationship with the superior mesenterial artery on the right and the superior mesenterial vein on the left."

"Looks like pediatrics isn't that bad, is it?" Meredith couldn't hold back a chuckle that was escaping her mouth.

"Oh, you shut up. You aren't even allowed here, technically. Robbins will be here any minute and then we'll do a contrast study. Are you jealous?" Cristina searched in her friend's face for any signs of jealousy. "I am but mostly because you get to be in the OR. I mean, even an appendectomy would be enough. Heck, I am really surgery - deprived when I am talking like this, aren't I?" Meredith stared yearningly and longingly at the x -rays. Crap, I am missing out on all the interesting cases. It's just not fair." She whined. Cristina laughed in response and earned a smak against the forearm.

"Hey. Stop that. You're not supposed to be hitting me." Cristina gave back.

"Then stop making fun of me. Because me being home on fricking bedrest just drives me crazy, as does Derek's overprotective hovering manner." She semi - complained.

"And I am on peds."

"I would like to be on peds right now if it meant surgery." Meredith sighed.

"I am scrubbing in on a potential endoscopy and maybe even a split-liver transplant after. I love it. As long as it doesn't involve dealing with kids and their relatives. Although it's not cardio. Some heart patient kids would have been more interesting." Meredith's brown furrowed as Cristina said this. "Oh, right. Sore point. I am sorry." Then she shrugged it off as did Mer.

„See, you've changed your mind. You, the children hating Cristina Yang, who only longs for cardio cases. But there aren't only cardio cases." Meredith smirked and that's what Cristina freaks out.

She doesn't hate children she just don't like working with them. Cristina didn't reply but then she did reply to Meredith's question, "As long as they're sedated and lying on an OR table ought to be cut open by some awesome surgeon, then it's fine. But I can't interact with them. I just can't …" Cristina told her. "You poor thing, working with little monster children, what a horror imagination for you." Meredith started making fun of her-

"Just shut your big, stupid mouth." Cristina hissed at Meredith who just kept giggling suppressed.

"Look at this." Cristina Yang said suddenly. She pointed at the images.

"What's this?" Meredith slowly asked, her gaze scanning the roentgenogram and the other images hanging there on the wall down in radiology. Meredith Grey immediately saw what was wrong with the baby, this patient. At least, she suspected it was a baby, since it was kind of obvious when looking at the images.

"How old is this patient and with what symptoms did the patient present?" She asked, eager to solve the medical mystery. Meredith's eyes were fixated on the diagnostic images. Cristina followed her gaze and answered: "Five day old male newborn. It presented with vomiting, distended abdomen, tiredness, sluggishness, it is lethargic …"

Meredith nodded. That seemed to fit the diagnosis.

"Okay, Yang, what do you see on the - oh, Grey." She abruptly stopped in the middle of her beginning sentence and almost stopped dead in her tracks when she saw the intern who had surgery less than five weeks ago. "I didn't expect you to be here, Grey. Haven't you had surgery a few weeks ago? Alex and Bailey may have mentioned that when I worked together with them on a case." The pediatric surgeon smiles brightly at her and Yang. "You aren't back yet, are you?"

Meredith rolled her eyes when she glanced to Cristina who replied with a knowing glance.

Why does everyone keep asking her that? Of course she isn't back already.

"No, I am not back yet and yes, I am the one with the CHD." She told the pediatric surgeon, knowing Arizona wouldn't need any further explanations.

Since she deals with that kind of condition on a daily basis - since she was a pediatric surgeon and pediatric surgery also involves pediatric cardiology, meaning the *surgical* treatment (in most cases) of congenital heart disease and not only pediatric gastroenterotology, pediatric oncology and lots of other specialties like neonatal surgery ... But she's rambling again, she probably should stop doing that.

"I hope you you convalesce well, Grey." Arizona smiled friendly at the intern who was standing there, in clothes of a civilian and still, Meredith Grey was down in radiology staring at some diagnostic images accompanioned by her person Cristina Yang.

"Well, I hope too. Anyway, what are you going to do about this?" Meredith questioned Arizona.

She pointed towards the images.

"I mean that is an intestinal malrotation and if it really it what it is you need to operate right away. Emergency laparotomy can be life - sving in those cases. But I think there might be something wrong with its doudenum." Sorry if I offended you with my behavior. I mean I am technically not working so ..." Meredith left that sentence unfinished.

"It's okay Grey. Nice of you to join us though. But I think, I can't really let you be here, can I?"

"You can, please. I just want to watch for a few minutes, then I am gone." Meredith tried to negotiate with the pediatric surgeon who seemed unsure of what to do.

"Well." Arizona said. "Meet me in Neonatal Intensive Care Unit and prep Jonah for his surgery. We need to be ask quick and thorough as possible." "Yes, ma'am." Cristina replied and made her way to the NICU. Before that she looked to Meredith who seemed to talk to Arizona.

"Okay, I will check with Bailey and then I'll get back to you. Is that okay?" Arizona asked Meredith.

She just nodded. Everything was better than just staying at home with nothing really to do. Since they can't do specific activities - at least not yet.

Meredith waited patiently for Arizona to get back to her. She came, together with Dr. Miranda Bailey.

"Grey. What do you do here?" She asked. "Wasn't I clear enough about the whole scrubbing in thing."

"You were, but this isn't about scrubbing in, it is about watching." Meredith countered.

"I was kind of talking to Cristina and then I diagnosed a baby with intestinal malrotation. Cristina stared at the x-rays when I came here. And I would like to watch them perform the surgery. I can't drive anyway, Derek's not here. He's probably with Mark, chatting with him about his whiny girlfriend who had to quiz due to the fact that intern exam is coming up soon - crap, I am rambling, right?" Bailey looked at her with an unreadble expression and cleared her throat.

"Fine, but you won't move a milimetre from that chair. Got it?"

Meredith was elated. "_**Yes**_."

"And don't do that."

* * *

When Cristina came to the NICU, she washed her hands before she entered it and put on this pink neonatal gown she needs to wear to protect the preemies for unneccessary germs they might get in contact to without the gown. So she didn't because she really didn't want to endanger small babies life's. It was enough that her friend's life had been on the line not so long ago. Cristina made her way through the incubators and the whirring noisy mechanical vents and all the other medical equipment to her patient. He was lying there, an NG tube through his nose, his eyes closed. Distended abdomen. On the roentgenogram she noticed the "Double - Bubble" - phenomenon. Which means doudenal atresia with intestinal malrotation. Also, he looked small. But that to expect considering that he was born with 36 weeks. His abdomen looked swollen as Cristina took his vitals.

Breathing and heartbeat were are bit quick.

Then Arizona came. She smiled at the baby and said: "Hey, let's correct your intestinal malrotation so you'll feel much better after." Then she turned to Cristina who scrunched up her face when she heard the pediatric surgeon talk like that. "I already talked to the family, they signed the papers. Let's get him to OR 2." Cristina nodded. "Also, Grey is watching the procedure. I got the ok from Bailey. As long as she only sits in the gallery it's fine."

"Since when do we do that? Letting patients sit in the gallery if they're supposed to be at home and rest." Cristina muttered under her breath. "Take it up with Bailey." Arizona replied. "If you have a problem with it, go to Bailey, she's your and Grey's resident so take it up with her." Cristina answered with a smile and said: "I don't have any problems, I am just worried that she will overdo things - which she does. I don't want anything happen to her. Ever since I know I can't help but worry she is my person ..." Arizona only listened, sometimes that was better and in this case it was.

While the boy was getting ready and prepped Arizona Robbins and Cristina Yang washed themselves sterile. First, neither the pediatric surgeon nor Cristina said anything, they just washed their hands in silence. Cristina suddenly asked: "What would you do when yor friend or someone you like has a congenital heart defect? How can you calm your mind when you know what can happen ... if every time when something happens you freak out and don't know if she will survive?" Arizona glanced at the hardcore surgeon who know wanted an honest answer. Cristina couldn't believe that she had actually confided in Arizona Robbins of all people. It just happened. Like she didn't have any control about it at all. But it didn't matter anymore.

"Or is this too personal?" Cristina's voice shook a bit.

"I don't know what you're going through, what Meredith ..." Arizona wasn't sure if she could use Grey's forename, if they were on first-name basis. "... is going through."

"I've seen parents go through it. Devasted, when they heard about her baby having a life-threatening congenital heart defect. It's hard. With kids, with little innocent kids, it is hard, it's always hard. That never changes. But I also know, medical knowlegde has gotten a lot better. Even if Meredith starts declining there are options, you know. If my friend had a condition like that, I wouldn't treat her as if she was sick. I would treat her as I treat any other friend who has not that condition, believe me, it's better if you do that. I know from teenage kids they just want to forget ... they want to do sports as normal healthy kids in their age ..."

Cristina nodded.

What Arizona told her seemed right. And it fits.

"Same goes for Meredith. It has taken her time, valuable time to come to me and tell me about her condition." Cristina said.

"Most ACHD - patients don't like talking about that. But it's important that they get regular, at least annual check - ups to monitor their heart fuction. Congestive Heart Failure often develops over time and it's good to catch it when it's NYHA I or II. It's easier to treat before actual symptoms start. Now, we have a patient open on the table." She ended.

"He isn't open yet." Cristina corrected. "He is about to be cut open."

"You're right about that."

"Hm."

"Let's save Jonah's life."

* * *

"Wow." Meredith mouthed, while she watched the surgeons work hand in hand to save this patient's life. Cristina was down there, operating with Arizona Robbins on this little patient. She smiled, she was like back in her element, even if she just watched a surgery it was still exciting, enthralling and fascinating. It was something that she was born to do instead of just sitting here, watching the surgery. She was jealous for a moment because Cristina got scrub in. then focused back on the surgery. "Good, this is so much better than lying in a bed all day. God, I miss surgery right now, how am I gonna survive the next few weeks. Tell me, someone." Meredith looked frustrated when she thought about that. She remembered what she had read about that condition.

Due to the potential for life-threatening midgut volvulus and ischaemic bowel, once discovered malrotation is corrected surgically. The general principles of treatment are what Cristina and Arizona are doing right now. Cristina opened up and Arizona did the following mobilisation of the bowel including untwisting any volvulus present, then the surgeons discovered that has also a doudenal atresia. That's why there was the "Double-Bubble" - sign on the roentgenogram.

"You see that?" Arizona asked her co - surgeon.

Cristina tossed her more precise glance into the body cavity. Then she replied: "Doudenal atresia."

Arizona nodded. "We'll have to correct that obstruction too."

But first they did the division of abnormal peritoneal bands eg Ladd bands.

Then Arizona widened the mesenteric base. Cristina watched and held the clamps. A fixation of the duodenum and caecum to the retroperitoneum (pexy) is not universally performed but in this patient they did it. "So, Yang. Question." Arizona started. "Is the anatomy going to be normal after this surgery?" Cristina didn't answer at first. Meredith bit her lip, she knew the answer and she hoped Cristina does too. "Come on, Cristina. I know this not cardio but you are good. You know it." Meredith muttered silently as she stared on the monitor. "No, it's not going to be anatomically normal."

"That's right." Then: "Grey, can you tell me the specifics?" Arizona had blindsided her.

Meredith nodded shorttaken.

"It should be noted that normal anatomical positioning is not achieved; the duodenum and small bowel remain on the right, and the caecum and colon are on the left side of the abdomen." Meredith answered as Arizona asked her the same question over intercom. Cristina looked up to her, Meredith sent her an reassuring smile.

"Now, let's fix the other underlying defect." Arizona perkily exclaimed.

In the end she asked: "Dr. Yang, would you mind do the honors and close up?"

Cristina nodded eagerly.

Soon her gaze wandered across the room to the monitor where she could see what was happening. She wanted to be down there. With them, holding that scalpel, watching Arizona making precise moves with the surgical instruments and held it to Cristina to let her make the cut ... that was all she needed for the world to be perfect. Also, not being born with a congenital heart defect would have been nice. Not needing medical attention whenever she feels sick or something is in any way weird. But you can't have all and sometimes the things you have are enough - at least right now, in this specific moment.

"Hey, there you are. I've been looking for you." She heard a familiar voice behind her.

"Derek." Meredith smiled at the neurosurgeon.

He glanced at Mer, searking for any kind of signs of exhaustion. She looked a bit tired but otherwise she seemed fine.

* * *

They were just coming home from the hospital, a bit more relaxed since they've both seen their friends and Meredith was happy that she got to watch part of a pediatric surgery on a newborn Cristina diagnosed with her help with intestinal malrotation and doudenal atresia. Now they were home again. "But what are we going to do with our free time? Since I do not have to work for two more weeks …" Pause, Derek didn't react. He pretended to sleep. "We could visit the Space Needle. I've never been there. Not even once, when I was a child." Meredith thought loudly, hoping he would consider her suggestion. Derek only grunted in reply before he really heard the meaning of what she said and sat up.

"You weren't … even though you lived her for what? … A few years?" Derek asked, he almost sounded shocked about the fact.

"Well, then it's time for us to visit it together. How does that sound to you?" Derek wanted to hear her opinion.

"I'd love to." She replied with a sweet voice.

"We can go next week, I am under strict orders to be an invalid." Meredith countered. "You know, to let my heart time to heal before I go kick ass in surgery."

"I know. And you're sexy when you say it like that."

Derek kissed her.

He smirked. "My mother was never big on doing normal free time activities that other people do with their families. She never made time for things like sightseeing or anything. So I am kinda new to this whole touristy - like thing." Instead of a reply Derek just kissed Meredith. Both seem to like this moment together. For once, only they existed. Everything else was blocked out. For a moment they forgot about Meredith being a few weeks post - op a heart procedure and Derek's accident. For some minutes they just sat there, frozen in a moment.

Suddenly Meredith asked a question: "But what do we do now?" She almost sounded childish. "Don't know." She got as a reply from semi – sleeping Derek. "Resting would be an option." Followed after. Meredith rolled her eyes. She had enough. She didn't just want to rest. She wanted to live, she wanted to use the time she still had before it takes a nosedive down. "Hmmpf." Meredith grumbled, she didn't seem to like that idea. She was feeling really good, better since before the surgery and everything that had happened. She feels strong, she was full of pulsating energy and the most important thing was, she was alive. The pacer really had improved her quality of life, if not greatly improved. It really had.

"I know what." Meredith's head shot up and then she sat upright in the bed, gazing at Derek.

"You can quiz me." She exclaimed and immediately handing him some medical books. Some pages were marked with green, yellow or blue post - it notes. Derek stared at the titles. "And what exactly am I supposed to do with all of this?" He motioned to all the books and the flashcards lying on their bed. "Quizzing me would be an idea. For a neurosurgeon you are pretty brainless." Derek groaned loudly and sat up.

"I don't that that meets the definition of resting." He mumbled suppressed.

"Oh, don't be like this. In a few weeks the big intern exam is coming up and I am still way behind the others in my class. I don't want to repeat the intern year because then it's like, Ellis Grey's daughter has to repeat her intern year. And that's all because of the whole heart surgery thing. So please I am begging you to do that for me. At least a few questions, it won't hurt, come on, Derek. Please. Some neurosurgery related questions because you are a neuro god and I am asking the neuro god who is also my loving boyfriend to help me study for my intern exam. Please, Derek. I need your help. I can't do this without you." Meredith looked at Derek getting big eyes, hoping he'll give in and do it. It didn't look like it though.

"Oh, now you're using your neurosurgeon boyfriend to help you through intern exam?" He replied firmly but then he smirked.

"I am not using you." Meredith defended herself.

"Forget that I even asked. I'll learn that stuff on my own. I've been on my own since college so …" Meredith just shrugged.

Amused, Derek watched her. He had already decided to help her but he wanted to tantalize her for some seconds. She loaded some medical books with other things on one stack, then she made an intention of grabbing them when she stands. Derek watched her actions and when he saw what Meredith was doing to herself because of him, he knew he had to stop form doing that her before she hurts herself.

The neurosurgeon jumped up from the bed so quickly that for a moment he experienced a little touch of lightheadedness but he didn't care. He had to stop her from carrying these heavy pile of books down the stairs or wherever she wanted to study.

"Mer." He called out, in the next second he stood next to her.

"Mer, don't do this." Derek told her.

"Why not. Why do you suddenly care?" Meredith snapped at him. She wanted to ignore him but she couldn't. "Hasn't Burke gone over the post - op protocol with you? The part of the protocol what tells you what you should do to support your recovery and what you shouldn't do to give your body the time it needs to heal fully and properly." Derek came slowly nearer, his eyes were telling him to let go of those books.

"What? I am supposed to be up and walking. He said that I should do that to train my strength. Short distances only but honestly, I do think bedroom to kitchen qualifies as a short distance. At least, I think it does." "You already said that." Derek remarked. "But what did he tell you about carrying heavy objects or lifting them. What did he say about that?" Derek inquired. Meredith though about choking off that demand but she decided against it. She sighed loudly. "No heavy lifting, I get it. But what do I do now?" She questioned no one in particular, kinda helpless. Derek smiled at her. Then he suggested with a smirk: "You could ask your loving boyfriend for a favor." "Derek, don't." She warned him. "What, don't?" He asked as he keeps giving her the McDreamy smile.

"Don't give me that face." She said but Derek just countered: "Oh, does it work." Meredith replied *seemingly* angry with him: "It makes me lose my point." "That's its purpose." He replied cockily. "Ass." She mouthed but never really meant it but she smiled at him. He knew she didn't meant it. "Let me carry them down." Derek offered. "Oh." Meredith said softly, she was surprised that he changed his mind.

"As you see, I did. I won't let you ruin all the good work Burke and Yang just did. They managed to repair your heart …"

Meredith shook her head. Derek forgot some important detail.

"They didn't repair it. My right ventricle still pumps the blood through my body. Nothing's really changed despite the fact that I have a pacer and a repaired aortic valve now. But everything else has stayed the way it was before." Meredith corrected him. "Wait, what?" Derek looked at her shocked. "I didn't think of that, sorry my bad." He apologized quickly. "Back to the point, do you have at any change written flashcards for the intern exam?" Meredith looked at him with hope. "I have, actually. Somewhere I still have them. I'll look for them promise. But now you said something about neuro quiz or something?" He asked. Meredith nodded eagerly.

"Thanks Derek for doing that for me. It means a lot."

"I know it does, we'll face any challenge together. And if that means quizzing you neuro questions for intern exam."

Derek smiled at her warmly. And Meredith returned with another smile and before they knew their lips met.

* * *

**_A/N: Thanks for reading._  
**

_**Intestinal malrotation is a congenital anatomical anomaly which results from an abnormal rotation of the gut as it returns to the abdominal cavity during embryogenesis. Although some individuals live their entire life with malrotated bowel without symptoms, the abnormality does predispose to midgut volvulus and internal hernias, with the potential for life threatening complications. Needs surgery to correct it.**_

_**A duodenal atresia results from a congenital malformation of the duodenum, and requires prompt surgical correction in the neonatal period. It is considered to be one of the commonest causes of a fetal bowel obstruction. **__**Patients present in early life with duodenal obstruction and associated symptoms of abdominal distension, vomiting and absent bowel movements. In complete atresia duodenum ends blindly with no communication with the distal bowel (and therefore no aeration distally). The atretic segment is usually just distal to the ampulla of Vater and the child has bilious vomiting. If the atresia is proximal to the ampulla, the vomiting is non-bilious.**_

**_I know some of you are still shocked about what I did to Derek. Maybe it was too much, I don't know ... I liked about this chapter the Cristina / Meredith discussing pediatric surgery - conversation and in the end with Arizona butting in. I feel bad for Mer that she right now can't be in the OR - which I will change, soonish I hope - but I'd really like to know what you think of this chapter. Reviews make me really happy ... as every writer in this forum._**

**_So please hit the button under text. It's right there._**

**_Reviews are greatly appreciated._**


	28. Chapter 28

**Chapter 28**

* * *

**Remember when we were little and we would accidentally bite a kid on the playground. Our teachers would go, "Say you're sorry", and we would say it, but we wouldn't mean it because the stupid kid we bit, totally deserved it. But as we get older, making amends isn't so simple. After the playground days are over you can't just say it, you have to mean it. Of course when you become a doctor, sorry is not a happy word. It either means you're dying and I can't help. Or it means this is really going to hurt. As doctors we can't undo our mistakes, and we rarely forgive ourselves for them, but it's a hazard of the trade. But as human beings we can always try to do better, to be better, to right a wrong even if it feels irreversible. Of course, "I'm sorry" doesn't always cut it. Maybe because we use it so many different ways: as a weapon, as an excuse. But when we are really sorry. When we use it right. When we mean it. When our actions say what words never can. When we get it right, "I'm sorry" is perfect. When we get it right, "I'm sorry" is redemption. **No Good At Saying Sorry (One More Chance); Meredith Grey

* * *

Cristina Yang was sitting on a table in the cafeteria, eating a salad and reading in some medical journal. Suddenly Izzie sats down on that table too. Confused, Cristina looked up. She hadn't expected Izzie to come around this time. But after George had yelled at them to get their act together, things looked different now. That's why Cristina didn't made any cynical and sarcastic comments when Izzie turned up. Without saying anything, she began to eat. Honestly, Cristina had no idea what that should be. So she went back to reading this interesting article about robot - assisted aortic valve replacements. Which sounded really interesting. Okay, it was cardio and cardio was always interesting but robot - assisted? She really wanted to see that some day as well as Situs inversus which is more than only rare.

"What are you reading in." Izzie asked. Cristina's brown furrowed slightly but she replied with a normal voice: "Medical journal, what do you think?" Cristina never looked up from the journal it was just so damn interesting to put down and have an actual conversation with a colleague at the same time. "Yeah, right. You wouldn't read anything else." Izzie gave back. "What's that supposed to mean?" Cristina's voice sounded slightly offended, feeling defensive. "Uh, nothing." Izzie back - pedaled as she heard Cristina's reaction. "Nothing? You better not want to take me for a fool, Stevens. You've done enough already." Ah, it always goes back to that. "Okay, fine. In the time I have known you, I've never seen you read anything else than these magazines about surgery et cetera." "Well, I hate reading trashy magazines, it's ..." She just shrugged. "I just don't like reading 'em is all." Izzie nodded. This was an awkward situation. At least now they can talk without biting one another's head off and that's a step in the right direction.

"Have you talked to her yet?" Cristina interrupted the stinging silence with throwing a blunt question in the room.

"Who should I have talked to?" Izzie asked. Cristina Yang looked at her in utter surprise, she can't think of any reason that is valuable enough for avoiding it. The big _it_. "Meredith." Cristina said while rolling her eyes.

"Meredith is the one you should talk to if you want to know how she is. I know how she is, we talk on a daily basis even if she is at home recovering from a major procedure." Cristina said, forked a bite and ate it. Izzie laughed for a moment. Both knew it was fake. "I know I should talk to her but I can't." Helplessly Izzie stared at the wooden table.

"I almost killed her with what I said to you. I made her run while she needed to be under constnat observation." Izzie shook her head, still couldn't believe what she did to her friend. "Well, yeah, that's right but I shouldn't have taken her there in the first place." Cristina said. "You admit you have done something wrong? Wow." Izzie was stunned. "You actually have acknowledged your mistakes?" Izzie made big eyes. "Yeah, yeah, big deal, barbie. Just get over it. I am rising ... you should too - talk to Meredith. She may forgive you but I don't know if I can ..." With that Cristina left the cafeteria. She had a patient who needed to be prepped for surgery.

* * *

**Cristina/Izzie; The tunnels**

_But Cristina Yang wasn't alone in the dark tunnels. Izzie was there too. With George. They were occupying the other gurneys. Izzie Stevens watched her. Kept watching her and it annoyed her. George stared against the wall as he tried not to make any sudden moves - out of fear, he could evoke some argument between Cristina and Izzie. Alex was somewhere she didn't know where. Cristina made a beeline for the gurney and let herself fall on it. For a moment she just lays on her back and stared at the wall. She then sat back up, stretching her arms. Izzie was watching her. "What is it, blondie." She asked without turning to her. _

_Izzie scoffed. "I am good. Thanks." "Doesn't look like it. You look like you would burst out into fire at any moment." Cristina stated bluntly. "How is she?" Izzie asked, looking to the ground. "I am not telling you. If you want to know, why don't you go and ask her yourself." Cristina shrugged her off. "You know what Cristina, right now, right now in this moment, I don't like you." Izzie told her bluntly. "Oh, I think that's based on mutuality. But don't ask me, 'cause right now I don't like you either." "I never wanted it to happen." Izzie protested. "Lame excuse. What's your point in doing that? I mean, you already know that I'll have the last word." "Just shut up." Izzie hissed._

_"Fine." Without another word, Cristina bit into her power bar and opened a book about cardiothoracic surgery. George just sat there, watching them how they get on each other's nerves. It was cold before Cristina got here but now with Cristina and Izzie in one room, it's all heated up - noticely. How much longer will they do that? It's starting to annoy him. So he decided to say something into the silence they were in: "Could you please just be friendly for a day? It's been what, three weeks between the incident and now ... I mean it can't go on like that. We have to get ourselves together and work out some solution. Because it can't go on like now." George was now breathing heavily._

_"It can't, I am sorry. We need to crack it. We need to get over it and focus on what is coming." Pause. "Cristina, I know you're blaming Izzie but here's the thing, it won't help matters." He turned to Izzie. "Same goes for you. I know you are mad at Meredith for never saying anything about the CHD but do you know that you have a big mouth sometimes and if you would have said anything to anyone the whole hospital would have known - accidently - but my point is, don't let it affect our friendship. I mean, currently there are some hardships but we'll get through them. We're MAGIC. We can do it without growing apart ..."_

_He sighed deeply. "I know we already do, but at least try. For me. Because I am not mad at Meredith. I get it. I get why she didn't tell us. But some things are better off if being left in the dark. That is what she thought. Even if she is wrong about it, she is still my friend, one my closet friends." George looked at Izzie and Cristina who were both silent. "Don't let it end that way. That's all I am asking. Get. It. Together. And. Pick. Up. The. Freaking. Pieces." With that George stomped off. It had astounded them, George's speech really had astounded them. Cristina was amazed, genuinely. Even Izzie looked like she would consider talking about her problems ..._

* * *

"God, they freak me out." Meredith whined. "My roommates." She answered Derek's unspoken question. "We can go to the trailer, spend some time on my land outside Seattle. It's quiet there, no one around for miles, we would be alone. We could make ourselves comfortable in my trailer ... I am sure you'll like it." He suggested without making stupid comments on her roommates. Meredith was thankful for that. She and Izzie still didn't talk. She only speaks with George who still lives here, even if only a few words per day. Between Izzie and Meredith was radio silence which was totally understandable after what Izzie did. Meredith stared at him. "In your trailer?" She asked, taken aback. "Your trailer …" But if she thought about it, she started to like that idea so maybe it wasn't so bad as it sounded, Everything's better than staying in this frat house every day and with no single chance to get out of here because you're supposed to recover. "It sounds good. I am fine. I am going to be back at work in five days. These five days we can spend on your land. I don't care about the cold or whatever animals are waiting out there for eating me. Bears, probably. But that's okay. Yes, trailer it is then. Let's pack our things and leave." Meredith saw her chance to get out of here.

"Not so fast, Meredith." Derek warned her. "Are you sure you want that? Nights, especially nights, are cold. You will get cold feet so that means you should probably pack some warm and fluffy socks when we do it. Also there is no hot water, we can cook but the kitchen is small, as in very small and that's gotta be spaghetti because …" Meredith shrugged. Cooking wasn't really that important. At least not for her. There is no one around for miles which means we would be on our own. Are you sure that's okay with you." He nervously said. "I am no Addison who hates living under these conditions / circumstances whatever. Low temperatures are fine, we just need to bring fleeces for us and enough blankets, extra warm clothes. It's gonna be fun, Derek." Meredith was very enthusiastic about the whole thing. "Come on, let's pack some things and then we go to your trailer in the woods." She said when he didn't move. "But what if you get sick?" He asked her directly. So that's why he's so unsure. "We'll take some antipyretic meds with us." Meredith had an answer for that question as well. "But what if you get sick, Mer. This isn't a joke, this is real. If you get a cold or a cough. You just had post - op pneumonia which is putting you at a certain risk to relapse. You could relapse, Meredith. I don't want to see you suffering the way you did back then. They had to put you on a fricking vent." He sounded extremely unsure of this at this stage if this really was a good idea. "I am just worried that you're doing too much too fast."

"Derek, I am going to tell you if I don't feel well. If I start having any symptoms I'll tell you. I promise. Okay? Then you can take me to the hospital and I get pumped full with antibiotics and that's it …" "But maybe not, Mer. Maybe this will send you into respiratory distress again. I can't go through that again. Not now, anyway, not when I could have prevented it from happening." Derek sounded scared, scared of losing everything that was important to him. She could hear it in his voice. "I am tired of being overly careful. I am feeling as good as I haven't in a very long time. I don't know how long that will last. But I do know that I want to spend this time with you. So, please, let's just do it. Let's spend out last days before work in the woods - just the two of us." She formed an inspiriting speech and Derek couldn't do anything but nod. "Fine." He said and planted a gentle kiss on her forehead. She replied with another placed on his mouth. Soon after that they started packing up the things they will need outside for the time in the woods. "Wow that's a lot of things." Meredith said, amazement in her voice as she looked over everything. "We're really going camping." "We are." "I've never been camping, did you know that?" Meredith confessed, a bit ashamed. "What? Really, not even that?" He asked back. Meredith just nodded. He pulled her into a warm embrace and kissed her on her forehead.

"No, what do you think? Camping isn't the thing that comes into Ellis Grey's mind when she thinks of free time. I don't even know if she knows what that is. She was addicted to work when she ..." Meredith didn't finish that sentence. "I'm sorry Meredith." Derek said silently. Meredith just shrugged. "It's okay. That was my life as a child. But sometimes when she got off of work we made great things together. It was rare but she definitely loved me as much as she was able to." For a moment there was silence between them. Nobody said anything.

* * *

Suddenly, the door to Meredith's and Derek's bedroom opened and George O'Malley appeared in the doorway, his face expression somewhat showed annoyance. He was late and Izzie was to stubborn. Which means he is the one who has to sort this whole thing out. "George." Meredith exclaimed as she saw him standing there. He leaned against the door jamb, sighing. "What is going on, don't you have to work today?" Derek slowly released his grip around Meredith. "I do. It's just that ..." George hesitated. Meredith looked at him with a blank expression, waiting for him to continue speaking. "George, just say it, I won't bite you or anything." She laughed a bit. George O'Malley shifted uncomfortably.

"Well, I ..." He stammered unsure.

Meredith looked at him and tells him to come to the point. "George, talk. I can't help when I don't know what's wrong." "I know. And I hate to ask but ..." Pause. "Can you call in sick?"

"For me?" Meredith chuckled.

"I think Bailey know that I'm on leave and that I'll be back in a few days considering she was one of my doctors when I had the surgery." "Yeah, I know. Can you, I mean, can you call in sick for Izzie? She isn't feeling well." He answered reluctantly.

Meredith turned to face George O'Malley, a spur of confusion covering her face.

"Why's that? Why would I do that, or better question why won't you call in?" Meredith asked lurkingly. "I am late and Bailey's gonna kill me, as in really kill me. That means scut and I hate being on scut, oh, crap that's a dumb reason, I am so sorry Meredith, I am ..." George spluttered. Meredith laughed. "It's okay, George. I will do it, what shall I tell Bailey? She'll want to know ..." Meredith looked at him expectantly and waited for him to answer. "If I don't know what's wrong with her I can't call in without a value reason, meaning, I need a reasonable explanation. So what is it?" She waited for an answer. Only reluctantly George opened his mouth to answer: " She's got a fever, a sore throat and a nasty cough. I made her stay in bed, she can't run around with that in a hospital. She'll only infect patients with whatever she has. So, you might wanna stay away from her." George warned her. "At least for now."

"I am not sick." Izzie called back from her room. "Quit screaming, Iz. You're just going to make worse."

Meredith Grey turned to Derek who was still standing behind her and his hand were lying on her shoulders. He just shrugged and smiled at her for support. "Fine, I'll call in." Meredith said sighing. "You should get your ass to work, George. Rounds start at six o'clock, don't they? Aren't pre - rounds at five o'clock? Because you're late, you know you're late." Horror was written on George's face as the realization hit him. "Crap." He got out. "Don't forget to make the call." When he was stomping downstairs, Meredith felt Derek's arms close around her. She turned to him, saying smirkingly: "See I am more likely to catch an infection here than in the woods. Would you like to revise your opinion? I am open for it, just go for it." Meredith grinned at him, triumphantly. "Maybe spending some time on my land isn't the worst of ideas when looking at the whole situation." ... that involves sick roommates. Derek gave in resignedly. Meredith had been right, again.

"Yeah." Meredith jumped up and said: "I'll call in, then I am ready to go. First, I'll go check on Izzie. Give me a sec." Meredith sighed. "Really?" Derek was surprised of his girlfriend's forgiveness and loyalty. He didn't know if he would have done the same thing when it wasn't anything life-threatening. Sure, he took an oath but ... "I know what happened between me and Izzie is not something you just get over. I know she really hurt me when she said all of this, she wouldn't even want to hear me out. I know this isn't perfect, I know I almost died because of that, I know. I am not downplaying anything ... it's just that blood's thicker than water. I am doing the 'being mature'- thing, you know." Meredith tilted her head a bit so she could look into Derek's eyes, she was speaking in a lowered voice so that Izzie wouldn't hear what she was talking about. "But she's also one of my friends. I just want to make sure she is okay and see if she needs anything and that she is gonna be okay when nobody's here. You probably don't understand why and you don't have to."

Meredith glanced at him for a second. "But please try to."

Her voice was incredibly strong right now, she wasn't letting on how much she had really hurt her when she did what she did to Meredith. She wasn't letting on any hurt feelings about Izzie had treated her the last time they have *seen* each other. "I support you no matter what Meredith, just do what you feel is right, what you have to do. I love you, you know that right?" Derek kissed her on the temple. "I am waiting for you and while I am doing this I am packing our things in the car." Meredith gave him a quick kiss before she headed to Izzie's door and knocked softly on it.

"Come in." Izzie replied, her voice was hoarse and raspy. The room was dark and Meredith needed a second to adapt to the darkness. "Izzie." She asked. "Mer." Came as a reply, now her voice was unsure. "What are you doing here?" She finally answered. "I want to know if you need anything." Meredith told her truthfully. She wasn't looking for revenge or anything like that, no, she was just being nice and helpful. Nothing more, nothing less. "I don't, thanks, though." Izzie reolied "You don't need to be nice to me after everything I've done to you." She now sounded embarrassed, very embarrassed. "It's okay, Iz. This is me and my better self. I am standing above myself so, yes, it's okay." Meredith replied sighing. "No, it isn't. I've willingly endangered your safety over my pathetic issues ... I've willingly condoned that something bad happens to you, Meredith. I am willing to accept the consequences even if it means being on scut for the rest of my internship and residency ..."

Meredith scoffed.

Officially, she was now standing on shaky ground. "I've hurt you - and I can't take it back as much as I want to. You almost died because of what I said. I was angry of you and Cristina, you are like a little closed circle that nobody can enter except if you're Meredith and Cristina. I was angry and I didn't think." "You didn't think? Is that why you cut the LVAD wire, because you didn't think? I've always supported you, when the Denny - thing happened I stood by your side. I was the one who treated his arrhythmias, why did you do this to me? Is it too much to deserve a little privacy? Apparently, it is." Meredith said calmly. "But I didn't mean to hurt you and ..." "And what? So now, you're looking for absolution through me, isn't it what you do? I try Izzie, I do but you make it so damn hard." Meredith's voice now rose slightly.

"Meredith. Please, I didn't mean it like that ..." Izzie begged her practically that Meredith hears her out, lets her define her position. She wanted nothing more than that. Meredith was on the door, her hand was on the doorknob. "Drop it, Izzie. I won't talk about it anymore. I have a phone call to make, Bailey is waiting for me to call in for you. Then Derek and I will go spend some time in his trailer." She said before she finally left the room. Before she left, she said: "Get well soon." "You too." She heard Izzie's soft reply, then nothing. After she did the phone call Meredith and Derek drove to the trailer to spend some time there. Meredith was amazed when she saw the plateau.

"It's Dr. Bailey on the phone." A sharp voice greeted her on the other end of the line. "Who am I talking to." She then asked. "Mere ... äh ... Dr. Grey." Meredith answered. "And yes, before you say anything, I am good. I am calling in sick for Izzie. That's all I wanted." Silence on the other end. "And why's she making you call in for her exactly?" There they are, the questions. "She didn't make me, George did." Meredith breathed in and stared at the wall as she waited for Dr. Bailey's reply. "And why is she calling in sick?" "A slight fever, sore throat and a nasty cough." Bailey sighed. "Fine. I let Cristina cover for her." "Hm." Meredith made. "Grey, I know you know that you're still recovering, right? So stay away for now, we can't let you relapse ..." "Bailey, I've heard this and there is no use in hearing it again. Anyway, Derek and I will spend the last week in his trailer which means I am not staying in this house. So no bacteria or virus that can make me relapse. I'll take care of me. I promise." "Good." After that Bailey hung up. "Derek." Meredith called out, "I am ready to go."

* * *

In their second day they spent in the trailer, it was cold. It rained the whole day long and rain just kept splashing against the windows. Neither of them were outside on this day. Luckily, they had enough food and warm clothes. They snuggled together into the blankets to reduce any heat loss. "Still thinking this was a good idea?" Derek was unsure. What is he going to do if she really develops a setback - at least an hour outside the city and with that Seattle Grace. He worries. "Are you cold, Meredith?" He keeps asking her in frequent intervals. "Derek, I am feeling fine. Look, I am covered with layers over layers of blankets, I am practically lying in your arms and you ask me if I'm cold? I am feeling free, Derek. This is relaxing. The rain, the just being with the person you love and all this ..." She motioned around. Derek's trailer was smallish but it was somehow cozy. And the bed, with all the pillows and blankets was very comfy.

Also, they could be as loud as they wanted. Nobody was around here for miles. So that was good too."So you're not cold." Derek wanted to make sure. "No, Derek. I am not." "That's good. That's good." He smiled and breathed in her scent. Her petite frame was lying next to him. When he touched her arm to check for any spikes in her temp, he was always relieved when he found out that it's within a normal range. Her skin doesn't felt warm to his touch and she was alert and talking to him. She seemed like the Meredith he knew before. "Derek." She suddenly said. "Can you stop checking my temperature? There is no need. I am a doctor, I feel when my temp's elevated and right now, I am perfectly healthy. So, would you please just enjoy being here and stop making yourself crazy about something that isn't there." Derek nodded. "Okay. But tell me if ..." "Yes, I will." She cut him off. "Do you want coffee or tea or something?" She asked.

"Oh, and can we open the windows to get some fresh air?" Meredith didn't wait for his answer.

She opened the window a bit. Took a deep breath and enjoyed the fresh air that was seeping into her lungs. For a moment she closed her eyes to enjoy this. "Are you sure this is ..." Derek asked worriedly. "It's fine, Derek. Otherwise we would have died 'cause of a lack of fresh oxygen." Meredith countered. "As long as I am fully clothed and lying around in bed there is nothing that's somehow endangering my health. I love you hovering over me but ... You're with me the whole time, Derek. There isn't anything that can happen to me as long as you keep an eye on me. If I am showing even the slightest sign of infection I'll tell you." Meredith reassured him.

* * *

On the Saturday before Derek and Meredith are supposed to be returning to work, he had planned out a surprise for Meredith. He could not really believe that Meredith hadn't seen very much of the city she lived in for several months now. Also, she had spent her first six years in Seattle. So Derek planned a day just for the two of them that involved showing Meredith some of the nicest and must see places in Seattle. He stood on the plateau and looked over the city. There were lights shining in all of the houses. The dawn already has broken, soon it would be morning.

This was the ideal place to build a house for him. For him and for Meredith and their children. They had spent the last few days in the trailer on his land. Meredith wanted to have some alone time with him and she needed an excuse to escape her roommates who were home when she was home as well - which wasn't very difficult when Meredith was at her house all the time. So Derek offered her that they could spend some time on his land in his trailer outside Seattle, far away from annoying roommates.

Then he heard footsteps behind him and he turned around. Meredith was standing there, her hands buried in her her pockets. It was a bit cold outside and that caused her to shiver a bit. But just a bit.

"Mer." Derek said, smiling widely. "Derek." Meredith said, a smile was covering her lips.

It was just her and Derek, alone in the *wilderness*. It was great, the togetherness. Just being here with Derek made her feel safe and happy and shiny. Not dark and twisty. "I love you." Meredith mumbled as she leans her head on Derek's shoulder. She felt his warmth as she watches the surrounding area, the plateau with the nice view of the city with its lights and everything. It was perfectly quiet, only birds and some insects could be heard making weird noises. "I love you too, Mer, more than you could ever imagine." Derek told her softly.

"I ... this is beautiful, Derek." Meredith suddenly said.

"You like it here?" Derek didn't want to get his hopes up and then smashed into little, tiny pieces.

"Yeah, I do. I've never been the nature - loving type of girl, never ... but this is different. Better. I think it would a great place for kids to grow up - our kids when we ... Or is this too soon, I mean we should probably not start with kids ..." Meredith lets out a nervous laugh. "God, I'm sorry Derek." He looked at her for a moment. "What are you sorry for?" He softly asked her, playing with a streak of her hair. "About the part with the children? No need to be."

"But my children will get Alzheimer's plus maybe a CHD. Me suffering from a CHD increases the chance that our unborn child will get an CHD too." Meredith told him. "They will get all my crappy genes." "I want your crappy babies." "Really?" Meredith asked back surprised. "All of them." Derek smiled at his hopefully soon to be wife and kisses her temple.

That was more she could ever imagine.

"I have a surprise for you Mer." Derek whispered as he felt her next to him, grasping for her hand, "You have?" Meredith asked. Her eyes lit up like a kid does when it can unwrap gifts ... "Yes, I do. I have it all planned out." He smiled with his McDreamy smile Meredith adores. "An entire day just us doing all the touristy - things your mom failed to do with you ..."

They both kissed.

* * *

_**A/N: Please review. **_

_**For those who read my other other story 'Holding On And Letting Go', I'll update as soon as possible. Thanks for reading.**_


	29. Chapter 29

**Chapter 29**

* * *

**Surgeons are all messed up. We're butchers, messed up knife happy butchers. We cut people up, we move on. Patients die on our watch, we move on. We cause trauma, we suffer trauma. We don't have time to worry about all the blood and death and crap it really makes us feel. Doesn't matter how tough we are, trauma always leaves a scar. It follows us home, it changes our lives, trauma messes everybody up, but maybe that's the point. All the pain and the fear and the crap. Maybe going through all of that is what keeps us moving forward. It's what pushes us. Maybe we have to get a little messed up, before we can step up.** Elevator Love Letter; Alex Karev

* * *

On the Saturday before Derek and Meredith are supposed to be returning to work, he had planned out a surprise for Meredith. He could not really believe that Meredith hadn't seen very much of the city she lived in for several months now. Also, she had spent her first six years in Seattle. So Derek planned a day just for the two of them that involved showing Meredith some of the nicest and must see places in Seattle. He stood on the plateau and looked over the city. There were lights shining in all of the houses. The dawn already has broken, soon it would be morning. This was the ideal place to build a house for him. For him and for Meredith and their children. They had spent the last few days in the trailer on his land. Meredith wanted to have some alone time with him and she needed an excuse to escape her roommates who were home when she was home as well - which wasn't very difficult when Meredith was at her house all the time. So Derek offered her that they could spend some time on his land in his trailer outside Seattle, far away from annoying roommates.

Then he heard footsteps behind him and he turned around. Meredith was standing there, her hands buried in her her pockets. It was a bit cold outside and that caused her to shiver a bit. Derek didn't notice which, honestly, surprised Meredith. He'd always seen when something was going on. But maybe he had been in thoughts and didn't really see what was happening around him. It wasn't that cold but it was a little bit windy, also it was still dark. Meredith took a few steps and then she was standing next to him. Just a few millimetres were between them. It was just them and the nature. No civilization or busy life. No, they were alone here. But still Meredith and Derek were staying somewhere near the city.

"Mer." Derek said, smiling widely. "Derek." Meredith said, a smile was covering her lips.

It was just her and Derek, alone in the *wilderness*. It was great, the togetherness. Just being here with Derek made her feel safe and happy and shiny. Not dark and twisty. "I love you." Meredith mumbled as she leaned her head on Derek's shoulder. She felt his warmth as she watches the surrounding area, the plateau with the nice view of the city with its lights and everything. It was perfectly quiet, only birds and some insects could be heard making weird noises. But otherwise it was perfectly quiet. "I love you too, Mer, more than you could ever imagine." Derek told her softly. Then again quiet.

"I ... this is beautiful, Derek." Meredith suddenly said.

"You like it here?" Derek didn't want to get his hopes up and then smashed into little, tiny pieces.

"Yeah, I do. I've never been the nature - loving type of girl, never ... but this is different. Better. I think it would a great place for kids to grow up - our kids when we ... Or is this too soon, I mean we should probably not start with kids ..." Meredith lets out a nervous laugh. She hoped she hadn't destroyed anything with her stupid little comment. Why the heck didn't she think before saying something. "God, I'm sorry Derek." She stammered. He looked at her for a moment. "What are you sorry for?" He softly asked her, playing with a streak of her hair. Meredith was relieved when she found out that he didn't freak out, more he seemed to like that thought of having children with her. "About the part with the children? No need to be." He said with a gentle voice, why was she freaking out about what she said? He thought it would be the other way around, that she wouldn't want to be her mother ... maybe because she doesn't want to put her kids through what she'd gone through.

Meredith didn't know what to think. He wants my ... "But my children will get Alzheimer's plus maybe a CHD. Me suffering from a CHD increases the chance that our unborn child will get an CHD too." Meredith told him. "They will get all my crappy genes." She said. "I want your crappy babies." Derek just replied, smiling at her dreamily. "Really?" Meredith asked back surprised. "All of them." Derek smiled at his hopefully soon to be wife and kissed her temple.

That was more she could ever imagine.

"I have a surprise for you Mer." Derek whispered as he felt her next to him, grasping for her hand, "You have?" Meredith asked. Her eyes lit up like a kid does when it can unwrap gifts ... "Yes, I do. I have it all planned out. Just you and me." He smiled with his McDreamy smile Meredith adores. "Really?" Meredith couldn't believe it.

"Yeah, really." Derek confirmed smiling at her, he shared her happiness about the upcoming trip.

"Will you tell me what?" She asked, her gaze looked intently at him. Innocent. Sweet with big puppy dog eyes. Derek gazed at her with his dreamyish self. Which keeps her from thinking straight. She starts sinking into his blue eyes. Derek pondered whether he should tell her a bit about what he wants to do on their last day at home, at his trailer before they've got to work. It would be Meredith's first day after the heart surgery thing. Then he decided that he would that her ... "Please." Meredith's eyes flickered and the glanced at him, hoping he would give in.

"An entire day just us doing all the touristy - things your mom failed to do with you ... " Derek trailed off. He didn't tell her what exactly he had planned it kinda would ruin the surprise effect. She'll know soon enough. Soon enough. "Will we be going to some fancy, elegant, romantic restaurant? 'Cause I don't think I have the right clothes for that." She bit her lower lip nervously. "No, we won't, actually, I have something different in my mind." Derek calmed her.

"But where do we go?" Meredith couldn't not ask. Derek expected that.

But he didn't tell her anything specific.

"It's a surprise." Derek just said. Meredith made a face. "C'mon, you'll like it." He tried to cheer her up. "Fine, but just because your're you." She answered, still a bit pouting. Derek just laughed and kissed her.

* * *

They were told that visitors can reach the top of the Space Needle by elevators that travel at 10 miles per hour (4.5 m/s). So Meredith and Derek looked for the elevator. "You and your thing for elevators." Meredith mumbled, Derek didn't hear her. Finally, they found it. "There it is." Both entered the elevator, they were the only one's using them right now. The trip only takes 41 seconds and both of them were surprised about that - since Seattle Grace has one of the slowest elevators. Derek was already outside, looking over the Sound, obviously watching ferryboats. The height wasn't a problem for him or at least it seemed like it wasn't. Meredith followed him a bit slower. Meredith was unsure when she entered the door that separated the observation deck from the rest. 'Cause this - this was really high. She needed a few seconds to adapt to the height, weil es so ungewohnt für sie war. Somehow even the air was thinner what she didn't really expect.

Meredith could hear seagulls cry, somewhere in the distance a ship tooted loudly. It was probably just about drive off and now wanted cast off, leaving the docks behind and with using the horns it wanted to make sure that other ships, small tourist trip shipping companies and sailboats, release the shipping passage. Presumably it is some cruise ship with a bunch of tourists on board, which probably wanted to visit Canada or maybe even Alaska. Lost in thought, Meredith looked at the colorful floating on the Puget Sound. It was beautiful up here - you could see from Queen Anne Hill to Lake Union everything. The houses, the buildings, however, were, when looking from this height, tiny. The cars too, but they looked even tinier. Here, they can see the city in miniature format. Actually quite interesting and a trip worth. Instinctively, she took a few steps to the side until she was standing next to Derek, who put his hand on her shoulder.

The view was pretty good today, there were hardly any clouds to see on the sky. That was something special, an occurrence she wouldn't mind to see on other days too. But now Meredith leaned against the railing next to Derek who looked over the Sound. "That's why I like Seattle." Derek suddenly said, motioning to the Sound and then to the lakes. There was water surrounding the city. The city's chief harbor, Elliott Bay, is part of Puget Sound, which makes the city an oceanic port. To the west, beyond Puget Sound, are the Kitsap Peninsula and Olympic Mountains on the Olympic Peninsula; to the east, beyond Lake Washington and the eastside suburbs, are Lake Sammamish and the Cascade Range. Lake Washington's waters flow to Puget Sound through the Lake Washington Ship Canal (consisting of two man-made canals, Lake Union, and the Hiram M. Chittenden Locks at Salmon Bay, ending in Shilshole Bay on Puget Sound). "Because of the ferryboats and that trailer of yours." Meredith mocked him slightly. "The ferryboats are a factor too, that's right. But one of the things I love in Seattle, isn't something material. It's about something I found in Seattle. I running from my failing marriage did something good too. Because here in Seattle I met you and that's the very best thing that's ever happened to me." Meredith just smiled, meeting Derek was one of the moments she'd never forget.

Then he feels Meredith's presence next to him and he acknowledged her. "Hey, look. Isn't that an amazing viewpoint, I mean you see the whole city skyline from this tower." Meredith nodded and let her glance slide over what she saw. "It is." More she didn't say. There was no need to do so.

All that matters is that she survived surgery and most important that she lived to be with Derek in this perfect little moment. Dedicated to just them. After a while, Meredith stirred a bit under Derek's embrace. "Wow." Meredith said as she let her gaze slid over the surrounding landscape which was just breathtakingly amazing. Everything looked so small from up here. "This is really high. How high is the Space Needle? Do you know that?" Meredith asked as the the wind blew through her her. She shuddered slightly. It was cooler than on the ground. Also, it was much more windy which was clear since Seattle is located between the saltwater Puget Sound, an arm of the Pacific Ocean, to the west and Lake Washington to the east.

"Maybe about 520 ft. But honestly, I have no idea how high this platform is. It's high, though." Derek replied, leaning against the reiling and held his face into the sun. They were incredibly lucky that is was today that was sunny. Meredith giggled when she heard his answer and faced him. He was looking exactly like Derek, who else should he be looking like?! if not like him. She stared at him incredulously as if she didn't believe him about what he said about the height of the Space Needle. He didn't really know that, did he? He might be the almighty neurosurgeon god but he does not know the exact height of on of Seattle's landmarks. "How do you know that." She couldn't help but ask. "Did some research about this when I planned our day." Derek chuckled slightly.

"They have a restaurant somewhere here too." Meredith suddenly said and as if her stomach wanted to send her a nonverbal demand that it needs food. "You're hungry, aren't you?" Derek asked, he knew her all too good. "Sea air makes you hungry." Meredith replied with a smirk. "In your case it seems like it does." Derek said, grasping her hand continued: "Let's see if there's a table reserved waiting for us, will we?" "That's great idea, actually." Meredith said, she was convinced as soon as she heard the word 'table' and 'reserved for them'. Derek really did plan something special ... He had reserved a table for them in a quiet corner with a great view over Seattle's skyline. It was perfect.

* * *

Cristina met George and Alex in the intern's locker room. She was really happy because she was on Burke's service today and she had spent so much time in other specialties that aren't that interesting for her as cardiothoracic surgery is. It gave her a rush, the kind of rush, other specialties doesn't have on her. It is only cardio that makes her feels like she's on top of the world. Cardio makes her feel like she's on a high. No other specialty does that. Cardiothoracics is the specialty she choses - although she isn't anywhere near fifth year of residency. Cristina was tired, she had spent the last three days in the hospital, nonstop. Nonstop surgeries what was great, she only rested for a few minutes in the tunnels whenever she had the chance. Now, with Meredith being at home recovering, there wasn't very much she could do. Besides working. "Yang, you have a second?" In an instant, everything was quiet. Everyone in the locker room had eyes on Cristina and Burke. To see whether this was work - related or not. It was, Cristina knew Burke's professional face.

Every intern in the locker room, even those who had other resident who weren't as good as Bailey was, looked to Burke and then to Cristina. "Ye ... yes." Cristina croaked, surprised when she saw Preston Burke standing there in the doorway. Alex Karev and O'Malley were shooting looks to each other, wondering what was going that Burke entered the locker room of the interns. Normally it's Bailey who does that and then tells them what to do for the day. Cristina looked around awkwardly as she sees all the interns gawking at her like she was some incompetent idiot who has done something wrong. But that wasn't the case. Hopefully. Hope dies last. "What are you looking at me? Don't you have something to do instead of gawking at me? Makes me wonder how you got through med school." Cristina retorted sharply and as she continued to outstare them, her last sentence had a sarcastic undertone. Burke never said anything, he just watched the interns practically fleeing. Not even a resident and already she was that intimidating. Astounding. "Cristina." He called her name for another time.

"Coming." She replied. Then she left the locker room, still feeling the other's glances on her back. "Burke. Why did you do that? That wasn't really clever considering ..." "Considering what?" Burke asked back, his eyebrows furrowed as he looked at Cristina. "Well, we have consult. Actually you do. You treated and diagnosed them before and now he's your patient." Oh, crap. Did she really screw up? Oh, god. What a disgrace. "Is ... is it my fault?" She asked barely audible. "Did I screw up?" She really didn't want to know the answer. "Do you remember the little boy you treated a few weeks ago? He's back and his sats are low. And it's your place to find out what's now going on, if he needs surgery or not. He is now your patient and your responsibility." Dr. Preston Burke watched her for a moment and the he gave her a small file with the patient's name on it.

_Flashback _ "Does he need heart surge__ry? That sounds terrific-" The anxious mother asked and stroked genty the hand ofher little boy. The parents looked at Cristina expectantly. Waiting for her answer. "In most cases, surgical repair isn't always neccessary. In his case, it's not. We just wait and see how he reacts. If he starts deteriorating we will consider surgical VSD closure but for now it is medically not neccessary. His hole between the chambers is pretty small and it's located in the muscular septum. It is quite possible that it closes in the next few years itself. Nevertheless, it must be observed regularly." Cristina told them. "Regularly. And with observing you mean check- ups or ..." Cristina nodded. "Yes, you have to come every six months for check- ups, the doctor does an echocardiography, pulse oxymetry and electrocardiogram and this will us if the VSD has closed itself or if there are any other problems with it. So there is no need for treatment. We know there is something and we'll do something if we have to. But in sixty percent of the cases the holes closes on its own. You don't have to worry." Cristina reassured them. End of Flashback _  
_

Now Cristina remembered. This was about the patient whom she had diagnosed a few weeks ago - he had a ventricular septal defect and obviously had now started to decline. "Okay, I'll figure it out." Cristina said, suddenly she was confident again. "Which exam room are they in?" She wanted to know. "They're in the ER. They panicked and went straight to the ER which means you have a consult down there. Also, you might wanna page Arizona to help you with the treatment." Burke advised. "Fine." Cristina rolled her eyes and made her way to the Emergency Department. At least it was cardio. Pediatric Cardiology, to be exact. As soon as she reached it she was greeted by hysteric parents and two crying children. Inwardly, Cristina groaned but instead she quickly began to assess the situation. "Are you the doctor." The first question she got thrown on her today.

"What symptoms have you noticed or what has gotten worse over the time. As you know he has a condition named ventricular septal defect. That we do know. It means there is a hole in his heart, a hole between his two ventricles." "We know. We looked up his condition on the internet, I mean you can get information there, it wasn't that difficult ..." The mother was worrying sick about her boy and talked seemingly nonsense. Great, this was just great. "What can you do to help him." The father helplessly asked as he held back his girl who didn't want to cooperate. "We have to wait, for the pending results before we process further." The father only nodded.

* * *

_He had planned it, way before anyone knew. Mark knew since Meredith has had her follow - up with Burke. He decided to tell him after Meredith's echo and the other tests came back clean ... He shook hands with Burke before he left the exam room. "Thank you for everything." He said, refering to doing Meredith's surgery and with that saving her life. "It's my job." He answered, although it was a hell lot different since Meredith Grey was Cristina's best friend and her person. But he didn't say that. He didn't have too. "It's not just that." Derek replied. "Anyway, we'll see eachother when we come back to work." That's when he went to Mark, Meredith was somewhere in the hospital too, looking for Cristina. She needed her friend, he knew that. But it also gave him some time to soeak things through with Mark. He really needed to talk with Mark about a few things.  
_

_Mark had betrayed his trust when he slept with Addison but at some point Derek realized that his marriage with Addison was over any way, even if Mark hadn't done the thing he had done. But despite all his flaws, Mark was still his brother and family - as was Meredith but not only in a brother - sister relationship or anything like that, no as in 'he wants her to be his wife who he spends the rest of his life with.' That's how big his feeling are for Meredith. And it took him so long to realize that he wanted her, okay, no that was wrong. It hasn't taken that long ... it was just that he felt like a better guy for walking away and trying to save his marriage. But it was the wrong thing to do. Now he knew it. Finally. Since they've been through so much, they can go through anything life throws at them, Derek was sure of that._

_It didn't took him long to finally find Mark. He was at the nurses station, flirting with them. God, he really needs a decent girlfriend, one who is more than just someone who he sleeps with. "Uh, Mark. If you could one minute without flirting to those nurses, I really need to talk. It's important." He urged. "Wait ... one sec, I ..." He smiled cockily at one nurse who even replied to this smile with another. "Mark Sloan, don't do this. This is only resulting in trouble. So I warn you, Mark." Derek said warningly. "Because you're family and family watches out for one another. This nurses thing - it isn't doing anything good." _

_"But they look up to me." Mark sounded like a little child who has something done wrong. "Still, Mark. Grow up and find her, your real love." Derek laughed. "Oh, what have done?" Mark said abruptly as he noticed Derek's behavior._

_"There is something going on, isn't it?" Mark grinned as he said that. He knew when something was going on. "Yeah, there is something I've planned. Secretly, if you wanna know." Derek's voice was sure. "But I think we can't about my thing here. Too much gossipy nurses and too many ears." Derek replied with a glance to the nurse who sitting there, typing something into the computer. She looked up and looked at Mark before she went away, carrying a pile of medical files of surgical patient. "Come with me." Derek said. "What about my patients?" He asked. "Ask an intern to monitor them." Derek replied. "They ain't all bad ya know." He laughed. "You're talking about Grey." Just a statement. Not a question. "Of course I am talking about her. Her condition does not affect her ability to become a great surgeon. Some may think that but it's not true."  
_

_"Calm down, calm down. I never said anything about that she can't be a surgeon, she can." Mark relented when he saw Derek's harsh reaction. "I am not just saying that because I am her boyfriend, I am saying this as Dr. Derek Shepherd, the neurosurgeon, and he is only looking at the medical point of view. And she's great in her job, thinks quick and acts quicker and knows a lot about medicine. Even the advanced knowledge for specific areas of expertise." He praised. "So you're thinking as the department head of neuro when you say this." Mark wanted to be sure. Derek nodded in response. "I am." He smiled when he thinks of Meredith working next to him on neurosurgical cases. Interesting, life - changing cases.  
_

_Both surgeons were walking across the hallway. Mark still didn't where Derek wanted to go. "Why don't we attendings have our own office? Then it would be a lot easier than it is now." Derek sighed loudly as he thinks of a place where they could go and be unheard of the nurses. Finally they found an empty OR gallery. There was no surgery so there won't be any unexpected surprises coming along to join them in the gallery. "So ..." Mark emphasized that word. "Will you tell me now what the hell is going on with you? You're running around lovestruck, everyone can see it. So what is it? Are you gonna take the next step with Grey? What would that be? Babies, maybe? 'Cause I don't know." Mark left the sentence unfinished._

_Derek goggled at him. "Mark. Babies are not the next step. I want us to be in a stable relationship, then we can think about having babies, or maybe we're going with one baby at first before we think of having more. Also, Meredith's body needs to be able to handle a pregnancy which means her having a baby would be considered as high risk. So, let's wait with the baby part for now." Derek replied dumbstruck. They were now standing outside the building, and there was no one except them. So that was good. "This is a big step, Mark and we're taking baby steps." "Okay, fine. Shep, it's okay, I understand." Mark answered. "Good, because there is another thing I need to talk to you about." "What is it? Just spit it out." Mark replied. Derek looked at Mark for a moment, then reached into his pocket and pulled out a little black box. "Oh what is that?" Mark exclaimed as soon as he saw the little black box lying in Derek's hand. "Don't you think that that's dangerous material?" He said.  
_

_"Quit making jokes, Mark. Now is not the time." Derek only replied. "So it's something serious." He concluded.  
_

_"I want to marry her, Mark. Since I met her that day ... that day in the bar, and everything that has followed after made clear that I love her and that I want to spent the rest of my life with her." "Are you serious." Mark asked. "I've never been so sure on something before. Okay, I was pretty sure that I wanted to become a neurosurgeon, I was sure about that too but I am also sure about wanting to spent my life with Meredith. I am sure about that." Derek breathed heavily.  
_

_"You're going to propose to her?" Mark asked his brother. _

_"I am going to propose to her." Derek confirmed with a smile on his face.  
_

_"Really?" He asked. "Really." Derek's face said that he meant it, he was really going to do it. And Mark would support him. Of course he would support him. He was his brother. "Can I be your best man?" Mark asked straight out. "Yeah, you can be my best man. I would be honored." Derek replied and grinned. "How will you do it?" Mark Sloan asked interested. "A day in Seattle and when we're on a ferryboat, I'm going to do it." Derek explained the whole thing. "You sure she will say yes?" Derek nodded. "We've been through so much together and we'll keep doing that - together. We love each other. We're meant to be or something. I am her knight in shining whatever." Derek's eyes sparkled in happiness as he talks about Meredith. "Uh, I get it. Just keep dreaming about her. You know Meredith and her friends call you McDreamy." Derek looks at him. "Who doesn't know that around here? Every nurse and every doctor knows what they call me around here." He just replied.  
_

* * *

"What about the symptoms." Cristina asked again. This time the father answered her question: "He's dyspneic, he barely drinks anything, he seems to be tired very often and he sweats a lot." Okay, she could work with that. That was more detailed and she already thinks of possible conditions he could have developed with that kind of symptoms. Since she already knows he was diagnosed with a VSD, maybe a pulmonary edema. Most kids with this kind of defect start showing symptoms when it comes to the decrease of pulmonary vascular resistance. That's what happened here too. So they needed an echo to see what was going on in there and some plain chest films to confirm the suspected diagnosis.

The diagnosis she had in mind. Before she did the echocardiography she took a listen to the boy's heart and lungs. There were crackles in the lungs that could indicate pulmonary edema.

"Okay, let's get this echo." Cristina told them as she prepared the apparatus.

When she started the exam, the boy's parents were watching her and then the monitor although for them it was just something that they didn't understand. The echocardiography revealed a large VSD unchanged with a constant left-right shunt. Due to the decrease in pulmonary vascular resistance, pulmonary circulation has increased more.

"We need radiographic images." Cristina ordered. She knew they would need them to check for pulmonary edema which can happen if he's in CHF. That's probably why Burke said she should page Arizona to. To let them know that they need a bed ready in the Pediatric Intensive Care Unit. "I need to see whether your son's heart's enlarged or not. You might wanna leave the room while I do this." Cristina said. The parents shared a look, then: "We stay." She got as an answer. "But you have to stay behind the glas. We work with x - rays, you know." Cristina told them as she organized the transfer.

Cristina waited for the images to load. But it was taking time. So she waited and waited, knowing she should page Arizona when she has the results. The chest films showed cardiomegaly, particularly left atrial enlargement although the right and left ventricle can also be enlarged. Also signs and features of pulmonary edema and increased pulmonary vascular markings were there, although the baby's chest films showed no pleural effusion. The MRI also showed added functional information e.g. quantifiation / shunt severity in addition to anatomy and demonstrated the typical appearances of a significant left to right shunt, in this case a ventriculoseptal defect or convincing consolidation. The heart is prominent. The shunt flow has increased over the weeks.

"I need to page Robbins." She said while doing it. And Arizona Robbins came running after a few minutes after the pediatric surgeon got the page from Cristina Yang.

"What do we have?" After Cristina explained everything to her, they decided that the baby should be transfered to Pediatric Intensive Care Unit to monitor his condition and his vitals. They started treating him for pulmonary edema.

The final corrective procedure was planned for the next day using an AMPLATZER® Muscular VSD Occluder to close the underlying defect. As for the boy, he's lucky that his congenital heart defect can repaired by simply placing an VSD Occluder to close the hole in the s eptum. For device closure of the defect the surgeons just needed a cath lab and the VSD Occluder. That was a minimally invasive procedure. It can be done with cardiac catheterization. So there's no need for a major open heart procedure that always carries certain risks. Okay, every procedure is in some way risky but this procedure limits the risks for the baby boy.

* * *

It was windy and a bit cold because they were near, or better on the water on a ferryboat near the railing. Wind brushed through Meredith's hair as she breathed in the the fresh sea air. There weren't much other people on the ferryboat. On the deck, they were all alone. It was too windy for the other's to be outside. So Mer and Derek were alone, exactly as Derek had in mind. He smiled at her, absorbed in thoughts. Meredith had no idea of what was about to happen. She had spend a great day with Derek in Seattle. Meredith and Derek spent the day running around Seattle. Doing all the things they've never had the time to do before. Working in the hospital had taken all that time. They visited Lake Union, where they did a nice picnic, and Queen Anne Hill, also they made a detour to downtown Seattle. All in all they had spent half the day near the ocean on the waterfront because both of them loved the ocean. It was special. She can't place it but she has a certain feeling that something great will happen to them. And she was right. But right now she just didn't know it.

_Something special was going to happen._

"If there's a crisis you don't freeze. You move forward. You get the rest of us to move forward. Because you've seen worse. You've survived worse. And you know we'll survive too. You say you're dark and twisty. It's not a flaw. It's a strength. It makes you who you are. I'm not going to get down on one knee. I'm not going to ask a question. I love you Meredith Grey. And I want to spend the rest of my life with you." Derek finished smiling at her with his gorgeous McDreamy smile. Meredith had tears in her eyes. This was new to her, someone that wants to love her, cherish her for the rest of her life. But since Derek she could ... She could imagine to live like that. Derek was her one and only.

"And I want to spend the rest of my life with you, Derek Christopher Shepherd." Meredith replied smiling widely.

"You do?" He couldn't help but ask. "I do." He got as a reply, without any hints of doubt or insecurity. Meredith was totally focused on the blue eyes looking at her intensively. These blue eyes made it very difficult to form a thought. But she was 100% sure about one thing: She wanted to be Derek Shepherd's wife. She was more than sure about that. Meredith just felt that it was the right decision, if not the most important in her life. From now on, her life would change - significantly. And that is a good thing.

It was just them in their post - engagement bubble.

It was a veeery pink bubble ...

They blocked everything else out, completely. It was just them and the world. "God, I love you more than you can possibly imagine." Derek smiled and suddenly both of his hands were on her cheeks and they kissed. Their world revolved only around them in this moment, everything else they just shut out. It was just them. Meredith and Derek on a ferryboat, kissing in the background the sunset. The sun went down slowly and painted with bright colors on the sky while the ferryboat gave a faint hoot as it was about to moor, they reached the ferryboat dock. But Meredith and Derek didn't think of getting off. They had spend a great day in Seattle, just the two of them. "I love you ..." Meredith whispered in his chest as she feels his arms around her and his breath on her hair. This was one of the moment she would never ever forget. Never wanted to forget. "I love you too." Derek planted a kiss on her hair as they stared both out of the ocean, or better Puget Sound. This is just the beginning of their never ending journey together ...

* * *

**_A/N: I hope you liked that chapter. More like the MerDer they used to be. Happier times for both of them, Derek and Meredith are engaged. He did it on a ferryboat, how's that?! As he always said, he has a thing for ferryboats (and elevators) and I kinda used it here. They need happier times ... We need them, too. What do you think? Please review. I just want to say that I've never been to Seattle nor to the US. I apologize for any inaccuracies and hope you enjoy ... I don't like the idea of Derek cheating on Mer a bit. In my mind Derek's never cheated on Meredith, doesn't matter how alone he may is in D. C. Hopefully Shonda doesn't destroy the MerDer couple ..._**


	30. Chapter 30

**Chapter 30**

* * *

**Everybody has something to hide. We can't just expose all our secrets to the world. That's how we get hurt. That's how we risk hurting other people. We have to decide how much we let out and keep the truth to ourselves. It's scary to reveal everything about ourselves. Fear makes us hold ourselves back. Is that so wrong? Maybe. Probably. But still. It helps to be a little sneaky, a little protective. It's not safe to just blurt out all of your secrets. We can't just lay all the truth out there. Expose ourselves to God and everybody. 'Cause once the truth is out, we have to face it ourselves.** The Great Pretender; Meredith Grey

* * *

"I'm engaged." Meredith Grey screamed into her cell phone as Cristina answered her cell. Cristina jumped when she heard her friend screaming into the phone. He held it away from her ear. Derek was outside the trailer. She loved spending time with him like that. "Woah." Came as a reply. Cristina was a bit shocked about the whole thing. How the states of affairs so suddenly changed. She needed a second or two sort out her thoughts. I mean this is big, very big. "You are what? Have I heard you saying something about ... He did?" She then asked. "Really? McDreamy proposed?" She clicked her tongue. "He did. Cristina, I never thought there was anything like happily ever after ... I never thought I could get my happily ever after but apparently, I just did. This is ..." Meredith was smiling as she talked to her friend, holding the phone to her ear. "This is ... it's amazing, the view from this side is amazing." "Ok, that feels unreal ..." Cristina finally answered. "You being all shiny and bright, talking about kids and marriage. You sure you ready for that?" She wanted to be sure that that was what Meredith wanted and not Derek. Meredith thought for a second, listened to what her heart was telling her to do and for once, mind and heart agreed. This wasn't some impulsive decision that turned out to be a mistake, no this was the right the decision.

"Yes, I am as ready as I'll always will be. I want that, I want that with Derek. I am all bright and shiny now, no more dark and twisty Meredith. She's gone now, and has been replaced by this Meredith."

"Oh, why can't I can't the old one back." Cristina whined. Meredith laughed at that reaction. "It was just right. I never thought I was that person until Derek showed me. I want a life with him, Cristina. I want to come home to him." Meredith smiled when she thought of Derek.

"Okay, you're making me vomit." She got as a reply almost immediately. She chuckled a bit, this was so Cristina - like. "That was the intention." "Okay, now I hate you." She said dryly. "Oh, you love me." Meredith replied smirking. She knew Cristina wasn't serious. This wasn't her tone "You just know me all too well." Cristina answered, sighing a bit. "Yeah, you could definitely say that. Oh, tomorrow I am going to kick your ass." Meredith said. "It's your first day after surgery, isn't it?" Cristina asked, happy that her person was back in the game. "Good you. I mean, it kinda is like hell without you being here." "I am coming back tomorrow." Meredith reminded her friend. "How come I forgot that?" Now that was pure irony. "Unbelievable." Meredith faked being hurt. "Cristina, what have you done?" She scolded her. "Nothing. You're really getting married? Woah." Cristina was still gobsmacked by Meredith's news.

"Yeah, I am getting married. I, Meredith Grey, child of the dark and twisties, is getting married somewhere in the future." Meredith replied. "Tell me!" Cristina suddenly said.

"How did he do it?" She urged through the phone. Meredith hear her voice even if she held the cell away from her ear because she was speaking so loud.

She didn't wait for an answer, didn't give Meredith time and room to even open her mouth.

"Elevator? I mean, elevator's are his thing, aren't they?"

Meredith laughed. The elevator was one of their favourite places. There has been a lot of kissing and sniffing between a certain intern and a certain neurosurgeon going on in there in the past. "Elevators are his thing but so are ferryboats." She didn't give her the specifics. "So he proposed on a ferryboat? Was it totally romantic, with kneeling down and all?"

"It was just us on deck, I was looking out of the ocean and Derek suddenly did it. It was simple but honest."

"Not so romantic also." Cristina said. "Doesn't sound like McDreamy." She then stated bluntly. "It was romantic. The was perfect, you cannot imagine how relaxed I am right now ..."

Then the door to the trailer opened and Derek entered the trailer, seeing Meredith talking on the phone. Cristina, he assumed. He let himself fall down on the bed next to her, his arms were suddenly embracing Meredith. He kissed her softly on the neck, then he wandered up to her cheek which resulted in Meredith giggling, even though she was still on the phone with Cristina, her twisted sister. "Derek ..." She said.

"What, I am just kissing my fiancé." He answered, a McDreamy smile covering his face as he looks at her with his blue eyes.

"Oh I sure can. Did you two have some hot engagement sex yet?" Cristina asked bluntly, she was not afraid of asking Meredith that question, Meredith would tell her anyway. Instead of answer, there were giggles heard on the other end of the phone. Then Meredith's voice came back clearer: "We're about too." "I see, I am hanging up now." Cristina grunted in reply as she hit the 'end call' button. She didn't need to hear Meredith and Derek when they were about to do this.

"She hung up." Meredith asserted that Cristina hung up on her.

"That's great, so we can have some alone time." Derek smiled at her seducingly. "Yeah, I know it would be a shame to end such a great day without dessert." Meredith planted a soft kiss on his lips ... Derek happily replied that with another kiss. Soon they were wild entangled. It got very late before they finally sleep, each of them with a smile on the face.

* * *

_The next day in the Shepherd / Grey household:_ Meredith Grey and Derek Shepherd woke up when their alarm clock started making noise what made it very difficult to sleep properly. "Oh, just make it stop." Derek grumbled into pillows. "Why is it ringing this early on? Who set this?" "I did, 'cause I am surgery - deprived and want to get on some good cases today. Just go with it, mister." Meredith kissed him quickly before she got up. "How can you be so perky at five o'clock in the morning." "I though perky was your thing, not mine. Coffee?" Meredith countered. "Yes, please." Derek groaned as he got up. "Sometimes I just don't do mornings." He said, running his fingers through his messy hair. "I see that now." Meredith smiled at him. "Why are you so ..."

"Potiential surgeries. Craniotomies, laparotomies, thoracotomies ... surgeries, Derek." Meredith explained to him.

"Oh right." Derek replied wearily.

"We shouldn't have stayed up so late." Meredith said as she sees Derek's exhausted feature. "Yeah, maybe." Derek mumbled something incoherent and yawned. "Hopefully you don't have any major procedures scheduled today that need your full attention and not the sleep - deprived version of yourself." She mocked him slightly. "I don't think they want you yawning in their brains." She giggled slightly.

"You're mean." Derek said, pouring himself a steaming pot of coffee.

Meredith was watching him. He seemed tired, why? They've been resting for the last days, there is now way he can be that tired. Lost in thoughts he took one sip, totally forgetting that it has been brewed only minutes ago and that it's therefore hot. But he seemed to forget that. "Derek, don't. It's hot, you'll ..." Meredith tried to warn him but it was too late.

She watched him, seeing his face expression change.

As soon as his nerves had registered that they sent a signal to brain to make him spit out the hot coffee. Derek's eyes went wide as the hot coffee caused pain. He then spit it out almost immediately.

The hot coffee burned his throat and he had tears in his eyes.

"H ... hot." He panted as he could breathe again.

"Yeah, that was hot." Meredith replied dryly. "I thought you knew that." She added. "Are you okay? Maybe you should drink a cold glass of water?" She suggested concerned. "I am fine, Mer. It was just hot and unexpected which is a bad combination." He said. "Maybe using your brain would be helpful to avoid things like that in the future ..." She offered. Derek only nodded. She patted his arm shortly before she made her way to find some clothes that would allow her to go on the streets without being weird looked on.

* * *

"Hey Mere you are back. Missed you." That was clearly Cristina's voice.

Meredith met Cristina in the entrance hall where she was headed for the elevator. Derek was on her other side but quickly saw that the twisted sisters needed some freakout time. So he headed alone to the elevator but not before he had kissed Meredith. "See you later. And kick ass." Derek whispered. "I will." Meredith chuckled slightly. "Now go. You have a bunch of patients you need to see, thanks to me." He shrugged. "No pressure, I took time off out of my own free will." Then he made his way to the elevator. Meredith winked as the doors closed, she just couldn't get her eyes off the man she will marry. Cristina noticed it too. "You're glowy." She stated. "Is it the upcoming wedding or ..." She didn't finish the sentence.

"Does his family know?" Cristina destroyed the happy mood with one question. "Have you told them?"

"No yet, Cristina. Let's just focus on the surgeries we'll be getting in." Meredith avoided the question. "Fine." Cristina Yang shrugged. "Come, Bailey's going to rip out our heads if we're not punctual. So just get your ass in the elevator." Meredith rolled her eyes, knowing her friend was right. When they got of the elevator, they heard the nurses talking - it doesn't take a genius to know what they're talking about. Some of them were staring, too. And that not even auricularly but so that it was obvious. Meredith wanted to disappear. Why can't there be no gossiping for once? Was her life so interesting that other people had to stick their noses into things where they don't belong? Was _their _life too boring?

Cristina's blood boiled.

She felt her person stiffening next to her. "Don't you have something to do instead of gossiping? Or if you want to gossip about something how about chosing something that does not have anything to do with her? Ever heard the word confidentiality? If not, you might wanna look it up. And you, Debbie." She directed this to an elder nurse who was typing something and talking to another nurse about what has happened. "You always say, we should treat you with respect. We have same rights as you then. This is a democratic country, same rights for everyone and so on. We won't tolerate that gossiping any longer, this has gone on long enough. There are people who want some privacy. So just stop sticking your noses everywhere where they don't belong. Meredith's life is none of your business. So stay the hell out of it."

Cristina was breathing heavily, Meredith still is looking intently on the ground.

This was kind of embarrassing but only a bit.

They've been walked over so many times with that ongoing gossip thing here - Seattle Grace has a serious gossiping problem ...

She knew she has gone way too far, way overboard but since she can't do anything about it ... But it felt good to stand up and say that. Chances are nurse Debbie will punish her later but it was worth it. Their faces have been worth it. They were shocked, blank - they hadn't expected something like that coming from someone who is on the bottom of the surgical food chain. But well, obviously it did happen. When Cristina and Meredith bolted into the locker room, they were alone. Izzie, George and Alex weren't there. "Well, let's get ready, then we'll hopefully catch some good cases." Meredith said eagerly as she changed from street clothes into light - blue scrubs. Then Miranda Bailey, their resident, was standing there with her hands on the hips causing Meredith and Cristina to jump up from the benches they were sitting on.

"Grey." Dr. Bailey said, everyone turned to her (the other interns who have other residents, they all knew about Meredith and the whole cardio thing), was looking and gazing at her as if they expect her to pass out any minute.

That's what she feared.

Meredith lowered her gaze, trying to avoid directing unneccessary attention in her way. But they were staring anyway. "Good to have you back." For once Bailey's voice was warm but firm. "Can I assume that you are ready to be back at work or ..." She left the sentence unfinished. Meredith got cleared by Dr. Preston Burke. She was allowed to work but she should take it easy for the first couple of days.

"I am ready. I got cleared by Burke." Meredith assured her.

Bailey huffed. "I am ready, really, I am. Also, being at home is more boring than you could ever imagine. I think if I had spent one more week at home, I would have died. Due to boredom. And you'd have to sign my death certificate. Cause would have been 'patient died due to expected post-operative boredom which was caused by staying home too long. Adequate therapy hasn't been tried.'" Meredith rambled. Bailey watched her.

When she had stopped she said, scolding: "There are certain things that you don't have to say out loud. Not everything that skips into your brain you have to say."

Meredith stared intently at the white hospital floor. But Bailey was distracted by the fact that the other interns weren't here yet. "Where are my other interns?" She asked, looking around in the locker room. "Where are O'Malley, Karev and Stevens." Her voice was now harsh. "Where are my ass - kissing, surgery hungry interns? Where are they?" She slowly said. "They seem to be running late." Meredith murmured as she turned to Cristina who nodded slightly. She had the same thought as her person. "Yang." Bailey suddenly said, causing Cristina to jerk a bit. "Yes, ma'am." She said, while waiting for her assignment.

She hoped it was something good. Like cardiology.

Or maybe even pediatrics and that was big, coming from her - who had no relation to kids in any kind.

"Yang." Bailey repeated her name.

Cristina waited for her to continue. "Burke is waiting for you, you're on his service today. From what I heard you're going to place a VSD Occluder in a boy with a muscular ventricular septal defect in cath lab." Miranda Bailey watched her for a second. "You got lucky, he could really use an intern." She trailed off.

"_Yes_."

Cristina jumped up. Cardio was her thing. Her thing. The thing she was brilliant at. The thing she wanted to do. "Now move." Bailey snapped as she sees that Cristina's still not moving. "Yeah, I am going."

Cristina rolled her eyes and left hastily the locker room.

Leaving Meredith all by herself with Dr. Bailey who is now asssigning Meredith. "You're on scut. I already know that you won't like it so don't even think about telling me that. I know it but I have no choice to have you do scut for this day." Bailey ordered her. Meredith attempted to protest but was cut from Bailey: "You're on scut. It's done." Bailey looked at her intern. Meredith wasn't fond of spending the day doing labs and updating patient charts. That was borderline boring.

"No." Meredith almost started to plead.

"But Bailey, I am fine. I am back to my old self before the whole cardio - heart related thingie happened. I am ready be back. It's what I was looking foward too ..." Meredith didn't give up on convincing Bailey to let her in on a surgical case.

"Stop right there, Grey." Bailey said harshly.

Meredith looked away awkwardly.

"You say you're fine?" Bailey came a few steps closer to Meredith.

You arrested more than just once. You've had your aortic _and _pulmonic valve replaced in one surgery and they implanted a pacemaker directly under your collarbone. On top of that you suffered from post - operative pneumonia which also threatened to take your life. And now you're standing here, telling me you're fine when you're obviously not. Also, you saying you're fine always indicates the opposite." Bailey finished her speech of why Meredith isn't scrubbing in on any surgical procedures today.

"So don't you dare telling me you're fine when you're obviously not." She blinked at her intern intimidatingly.

"But I am." Meredith protested although she knew she doesn't stand a chance against Bailey. Bailey was the one who has the last word, as much as it annoys her she has to go with it. "Grey, I don't think that's a good idea." "C'mon, I've doing nothing for weeks now. I thought would feel the greatness, the spirit as soon as I am back in the operating room. It's what I looked forward to since my surgery." Meredith tried to persuade Bailey which obviously wasn't working. "You aren't giving up, are you Grey?" Dr. Miranda Bailey asked and eyed the intern who was standing there.

* * *

**_A/N: Hey, I know today's Grey's Anatomy - Day. And you're probably all watching it ... But maybe you'll leave a review anyway ... Hope you liked it although it was very short._**


	31. Chapter 31

**Chapter 31**

* * *

**We assume the really serious changes in our life happen slowly, over time. But it's not true. The big stuff happens in an instant. Becoming an adult. Becoming a parent. Becoming a doctor. One minute, you're not, and the next... you are. Ask any doctor, and they can point to the one moment they become a physician. It usually isn't med school graduation day. Whatever it is... nobody forgets it. Sometimes you don't even know anything's changed. You think you're still you and your life is still your life... but you wake up one day and you look around and you don't reognize anything. Not anything at all. You never forget the moment that you become a doctor. A switch flips. Suddenly, you're not playing dress-up anymore. You own the white coat. What you may not notice is the moment that being a doctor... changes you.** Blink; Meredith Grey

* * *

"So don't you dare telling me you're fine when you're obviously not." She blinked at her intern intimidatingly. "But I am." Meredith protested although she knew she doesn't stand a chance against Bailey. Bailey was the one who has the last word, as much as it annoys her she has to go with it. "Grey, I don't think that's a good idea." "C'mon, I've doing nothing for weeks now. I thought would feel the greatness, the spirit as soon as I am back in the operating room. It's what I looked forward to since my surgery." Meredith tried to persuade Bailey which obviously wasn't working. "You aren't giving up, are you Grey?" Dr. Miranda Bailey asked and eyed the intern who was standing there. Meredith nodded slightly. "I am not giving in yet. This is what I am born to do. It's what I _want_ to do day in, day out. I want to be good at what I do and the way to be good at things you need to practise and practise over and over again." Meredith tried the 'I am way behind' - card."You're a natural Grey. I've seen that on the day you started. You don't have to worry about falling behind." Bailey told her, not knowing if it was the right decision to let her know that.

"I am? You're not just saying that because I'm Ellis Grey's daughter?" Meredith asked back.

Dr. Bailey eyed her intern. Everyone of thinks of Ellis when they hear the name Grey. Meredith seemed insecure and skeptical in this moment. Even Bailey saw that. Bailey huffed in response. "Do I look like someone who favors someone because of their blood? Am I that person?" Meredith shook her head. "No, I know you aren't but sometimes it's hard to believe someone, especially here." Meredith looked to the ground. "This has nothing to do with you." She added quietly. "Thanks, though. But if you think a have potiential then why can't you assign to someone where is actual patient interaction, not just running labs and all this ... If you don't mind can I please get assigned to a surgeon who lets me scrub in on an actual surgery?" Meredith's voice held a desperate plea.

The general surgeon sighed loudly. This was difficult, a difficult situation ... a difficult decision ... one she she never wanted to make for her own interns. She was supposed to boss them around, not to go soft and actually consider that she assigns Meredith to another attending instead of letting her running labs all day.

"Grey. I know you missed a lot but see, it's for your best. You've been through a lot these days. Your ribs need time to heal. They need circa eight weeks to do that. Just this day, Grey and then I can think about assigning you to someone who teaches you something. We need to see how you respond and adapt to the pressure. This is hard, I can imagine it is. But I don't know. It's not what you signed up for ... but it's not the end of the world. All you need is a little faith." Bailey finished her pep talk.

Meredith nodded.

What else was she supposed to do? She was about to go as another though swooped into her mind. "Thanks, Bailey, for everything you've done when I was ... I'll never forget what you and Burke did for me when I needed that surgery."

Meredith looked at her resident.

"It's okay, Grey. If I hadn't done everything to save you, or if we hadn't done everything we could I would have needed to deal with a grieving and devasted Derek and Cristina for the rest of my life. You dying would have had an effect on everyone, Grey, not just them. You are very well liked around here.

Meredith scoffed. "Maybe that was before this happened. Now everyone just stares."

You know yourself that that is not true." Bailey replied with a frown, not quite knowing what she meant with that comment.

"Meredith didn't know what to reply to Bailey's relevation. Then she feels like she has to say something. "From now on I will tell if something feels not right, if I think my heart's causing problems." Bailey just waited what Meredith has to say. "I don't want it to play out like this again. I mean there is a change that my state's going to worsen some day ... I know the odds, I went to med school. I've read every literature about congenital heart defects since I got into college. I know what can happen. I am well aware of the odds. If my right ventricle starts to fail when it can't take up with the pressure anymore, and there _is_ an actual chance that it will happen one day, that means hospital stays, a lot of them, actually. I ... I don't know if I want that."

Silence.

Nobody said something. Bailey didn't really know what to say. "I never thought I would need a pacemaker but yet, I did. It did happen. My point is you never know." Meredith trailed off.

"You never know." She added a bit quieter.

It sounded a bit like she's given up.

But she hasn't.

"I don't know what will be three months from now. Maybe I'll be okay, maybe I'll start declining. Maybe I'll live for another forty years without any problems. But I don't know, all I can do is living. There's no planning for the future 'cause you don't really know if you will have one." Meredith shook her head.

"Sorry for bothering you with my crap. We all have problems. It's just that ... I needed someone to listen. Someone who's not shutting me up as soon as I talk about these things. They're kinda important even if they don't want to accept that. Everyone, Derek and even Cristina tells me that that's not gonna happen but what do they know?! They don't know."

"Yeah." The other interns still weren't here. Bailey and Meredith still were alone in the locker room, Meredith was telling her some intimate things she will never mention to anyone. Kinda like doctor - patient confidentiality.

"They avoid but they know as well as I do that that can happen. Doesn't mean it will but it can."

"Everyone around me avoids ... They deny, they avoid ... I am really sorry for bothering you with my crap, again. I should probably get started with completing my files otherwise I am gonna sit there till midnight. I am not complaining though. I really should ... Oh, damn ... I am sorry." Meredith called out hastily.

She had started to ramble again. She had a hard time stopping when no one stops her and she rambles. And now it was too late.

Maybe she would get scut for another day.

Chances are she might would. It was the most likely thing happening. But it came totally different. She was surprised about it and so was Bailey ... Meredith never thought she was the hugging type of girl.

Damn rambling.

Meredith Grey avoided to look at her resident, who was now frowning and gazing at the figure that used to be strong intern that she's known before the cardio thing happened. "Oh, Grey." She said, that came as a soft reply.

But not, that's not gonna happen. She knew Meredith was right, that it, the unspeakable, really could happen. And that was a terrifying prognosis. She just hoped it would never come to down to that point. There were no guarantees for anything. It could happen tomorrow ... Fact is, the unspeakable can happen. Although nobody wants it to happen.

Dr. Bailey pulled her now vulnerable looking intern into a hug. Obviously seeing that she needed a bit of comforting. "Oh, Grey." She repeated in a soft voice. Then after a few seconds she let go off her intern. Meredith smiled at her and pulled a streak out of her face. The streak was annoying her. "That's the last hug you're gonna get from me." Bailey said, knowing she had shown her intern the soft side of her.

"Thanks ... and sorry but sometimes I have a hard time stopping when no one tells me to." Meredith tried to explain.

"So I've noticed." Bailey replied with a smirk covering her lips.

Meredith let out a nervous laugh.

"And Grey, don't ever, ever tell anyone about me getting soft for once. If you do, I'll make the rest of your internship and residency a living hell." Meredith nodded when she heard Bailey warning her. "I won't tell, promise. By the way, it was the right decision to put me on scut, even if I don't like it." Bailey was surprised, she hadn't expected this in her dreams. "Why's that?" She wanted further details why her intern suddenly changed her view about things like this. Meredith glanced to her before she continued. "I know it's not really my place to say something and I know that haven't been easy ..." Meredith trailed off a bit.

"... but you did the right thing. I don't want any special treatment. Treat me as you would treat any other intern around here. If I am slackingdoing the work I am supposed to do, put me on scut. I don't want the others in my class to think I get extra surgeries or free passes, or *get out of jail free*- cards just because I am a heartkid. It should be fair to anyone ... Me ... The others ..."

"I don't want surgeries out of pity. I don't need that. I don't want that." Meredith told her. "I want them because I deserve them, because I worked hard to get in on that case or join that OR orgetting that specific surgery, whatever. Just don't favor me. That's my only concern." Meredith looked at Bailey who seemed genuinely surprised.

"I appreciate your loyalty, Grey." Dr. Bailey smiled genuinely.

"But I never eould have favored you, Grey. But it's shows your loyalty that your saying this." Bailey said.#

"Good. Because I am no different than the others." Meredith replied.

In this moment, Izzie Stevens, George O'Malley and Alex stomped into the locker room. They were talking. Alex noticed Meredith standing there. "Hey, grey." He said. "First day back after big surgery, huh?" He asked. Meredith nodded in response and smiled at him for a moment. "Yeah, I need to go, I have to run labs for Bailey. See you later, Alex? Cafeteria with me and Cristina?"

"Done." Alex replied.

"Great. Looking forward to it." Meredith then left the locker room, leaving them alone with a Bailey who wasn't very pleased.

* * *

"Hey, Izzie." Meredith said as she tried to find Dr. Bailey to give her the lab results. "Meredith." Izzie shortly acknowledged her presence but said nothing more. "I have the lab results for Dr. Bailey. Would you mind giving them to her?" Meredith asked the blonde surgeon in a friendly voice. She started to have a conversation with her friend. But apparently, Izzie had other ideas playing in her mind. "How do you know I am on her service?" Meredith very wisely ignored Izzie's taunting comments. "Never mind, I'll just do it myself." Meredith Grey immediately knew where this went so she tried to stop it before it even started. "Would be a nice idea since everyone knows your little secret is out." Izzie quipped in a hostile voice. Meredith just shrugged.

"Well, it's not my fault that I have been born with such a condition. Believe me when I say that I would gladly appreciate a normal life with a normal, healthy heart as you are."

With that, Meredith stormed off to find Dr. Bailey, leaving Izzie standing in the hallway. Meredith found her talking to another surgeon, Dr. Stehlke, a german surgeon who's only temporary working at Seattle Grace.

When Bailey finally noticed the young doctor she interrupted her conversation with the older colleague and looked at her. Meredith cleared her throat as she began to speak. "Dr. Bailey, I have your lab reports. What should I do know?" Meredith asked her superior as she handed her a stack of papers. "You can do post - ops in 2043, 2027, 2780 and 2658 including ECG. If tey haven't done one, do one." Bailey told her. "Fine." Meredith said, sighing. This wasn't how she imagined her first day back. "Also, Mr. Green in room 2385 needs a new central line that I want you to place. Then, Mrs. Baxter's pre - op labs need to be checked."

Meredith frowned. "Isn't that Izzie's job. I mean I'll do it, no question, but she's the one scrubbing in on the adrenalectomy-" Bailey shot her look, but didn't answer. It wasn't neccessary.

Meredith went to check the pre - op labs and noticed an abnormality as she read through the results.

Later, she found Izzie in the hallways with George O'Malley boasting about the surgery she was going to scrub in with Dr. Bailey. "Can you believe it? An adrenal surgery?" They didn't notice Meredith standing there, listening to their conversation. Izzie had forgotten to check her pre - op labs. Apparently, she didn't think of it. Before that surgery Izzie already scrubbed in on a simple hernia repair. But that was okay. She'll get her chance. Which is now, apparently. So Meredith silently left Izzie and George without even thinking of reminding her that she has to check her patient's pre - op labs.

"Bailey, wait. I ... I need to ..." Meredith panted after she had run after Bailey.

"Are you okay, Grey?" Bailey asked, frowning when she noticed the panting of the young doctor. "Look." Meredith didn't reply, instead of doing that she showed Bailey the lab reports. "I noticed an abnormality, the labs showed a low platelet count, vWF is normal, so there is no way this can be _von Willebrand's disease_ ..." She just ignored the question. She was doing great. Pacer was doing its job ... new aortic valve as well ...

"From what I see, these labs indicate idiopathic thrombocytopenic purpura." Meredith explained.

Bailey grabbed the paper and scanned it, she read over the results.

"You're right, Grey. How come we missed this."

"No idea, never been on the case but I believe it was Dr. Stevens who took her medical history." Meredith answered. "I think I need to have a little talk with Stevens. Grey, you go prep Mrs. Baxter and then you call the blood bank and make sure we have enough platelets if we need them. Also do a repeat blood work and talk to the the patient, ask her if she's had any specific problems with it."

"Will do." Meredith replied and went on her way to do that. She entered the patient's room and noticed that they were already prepping her for surgery. "Mrs. Baxter, I am Dr. Grey and I will go over the post - op protocol with you. Also we'll talk about contingent questions - if you have any." Mereditth said as the nurses had left the room and she was alone with Mrs. Baxter. "Oh, that's so nice." She said. "But where's the blonde doctor who was supposed to be on my case?" The woman asked. "You mean Dr. Stevens?" Meredith asked in a friendly voice. "Yeah, the blonde doctor." The woman insisted. "She isn't available. She got called away by another case." Meredith *lied*. She couldn't tell her that she had missed something on the lab report. "Okay. So you're gonna prep me for surgery, Dr. Grey ..." Apparently, she had read her name on the name tag that was connected to the lab coat. "Will you be there?" She asked, sitting up.

"Yeah." Meredith said, relieved that the patient came around. "I will. But I have to talk to you about your blood test results." There was a short pause. Then the patient said: "Oh, damn, I totally forgot to mention I have hereditary / chronic ITP." Meredith sighed a bit.

_She forgot to tell them that she (the patient) has a blood disorder._

_At least they had seen that on the lab report she'd done twice._

"Did you have any problems with it? Maybe even a splenectomy because other alternate treatments wouldn't work?" Meredith asked, scribbling something down in the chart. The patient thought for a few seconds. "I don't really have much problems with it." She then said. "I live a normal life. Mostly, there's just bruising, sometimes petechiae but otherwise I can't complain." The woman smiled at her for a moment.

She was acting very normal even if she was about to have surgery in a few minutes. After Meredith and the patient had talked another five minutes about everything, the surgery and the possible complications, they were finally ready for the surgery to start. After the patient was anesthized, Meredith left the OR to scrub in. Bailey also entered the scrub room, looking at her intern for a millisecond and then said: "Did you get all the information you need, we need to properly perform the surgery on this patient." Meredith nodded in reply. "I do, apparently, she hasn't had very much problems with the condition nor did she have a splenectomy." Dr. Miranda Bailey nodded before she entered the operating room. "Scrub in, Grey."

"What?" Meredith exclaimed. "I didn't think I would, I thought Izzie was the one ..."

"But Izzie Stevens didn't figure it out, you did. It would be unfair if I had let her scrub in even if she didn't found out about the condition. But Grey, if you want to you can scrub in.

_An adrenalectomy. This was a procedure she'd wanted to see since med school._

_It was a great opportunity and ..._

Before Meredith could form another thought Bailey completed: "You've earned it. Now go scrub. We're starting." Meredith nodded. She had made her decision. She wanted to scrub in on that surgery.

* * *

Before the procedure, the Dr. Burke and Dr. Yang discussed any remaining questions the parents have, and they asked them to sign a consent form. A consent form is standard in any surgical or invasive procedure. It explains the procedure, risks and takes the parents and doctor's signatures. "Okay. It's signed." The mother said in a shaky voice. "Pssh, baby boy. We'll see you after." She cooed to the baby who didn't really know what was happening to him. They used general anesthesia to keep him calm and properly positioned during the catheterization procedure. "Is this procedure safe?" The mother asked again. Cristina suppressed a deep sigh. There were risks to every procedure but ... Dr. Burke looked over to Cristina, as he would say that she should answer that question.

"Cardiac catheterization procedures are less invasive than open surgery, so they are inherently associated with fewer risks. Newborn babies with congenital heart defects benefit greatly from catheter-based procedures either to diagnose or treat these problems. In your son's case, we'll treat it in there. Catherization is the better alternative to open heart surgery which would be invasive and therefore, there are more risks. Doing the VSD closure in the cath lab has a few benefits such as shorter hospital stays, quicker recovery time and less discomfort and scarring than conventional heart surgery." Cristina reassured the parents again. "Okay." After the parents were ready, they took him down to catherization lab.

"Let's start." Burke said. "Let's do this."

Cristina nodded.

"Are you ready, Cristina, to perform your first VSD closure via catheter?" Burke asked.

"Wha ... Are you serious." Cristina was shocked, as she looked at him.

"Yeah, I am. Are you?" He asked. Cristina just nodded. She didn't know what to say right now.

A thin, flexible tube called a catheter is threaded through a blood vessel in the groin, or sometimes in another location, and into the heart. Through the catheter, the doctor can measure pressures, take blood samples, and

"Injscting the dye." Cristina said as she watched the monitor. She injected the dye (contrast material) into the chambers of the heart or blood vessels. Now you could see the blood vessels clearly. At the same time, she threated a catheter to the baby boy's veins to his heart. Burke watched her doing it. The doctors watched the movement of the dye through the heart's chambers and blood vessels.

Dr. Yang was also going to treat the underlying defect, she moved special tools through the catheter into the heart. She used these tools to correct the defect. Soon after that she had closed the ventricular septal defect with a VSD Occluder. The catheter are removed. "I'm done." She said, motioning to the patient."Good work." Burke said, he had watched every step in the whole procedure and it has been done flawless. That was Cristina for him. "You did good." He said.

"Well, I had the best teacher." She smirked at him for a moment.

"I bet." Burke replied somewhat cocky.

After they had told the parents, Cristina went to the OR board, trying to figure out which OR Meredith must be in. She had heard Izzie talking about the unfairness that had happened to her, that Meredith stole her surgery out under her fingers. But she didn't believe Meredith would do something like that, there was another part to the story that Izzie knowingly forgot to tell Cristina. But that wasn't important right now. She should go check on her patient before doing something else.

The patient won't need anything else than annual follow-ups. That was a pretty good outcome. The baby's parents were happy that their son was doing so great and that the procedure passed off that well. There were no words for describing that kind of feelings. In short, Cristina was happy.

* * *

After the patient was under, Bailey entered the OR. She had allowed Meredith Grey to scrub in after Izzie wasn't focused on what she was doing. Meredith was still in the scrub room when the door suddenly opened and an angry, raged Izzie was standing there, obviously she was flying into a frenzy. "_YOU_!" She exclaimed loudly. "Why the hell did you steal my surgery. This was mine. Mine. And you stole it." Izzie shouted into Meredith's face only to be met with a non answering Meredith. She panted as if she had run the whole way from wherever she came from. "You stole my fricking surgery - the one I was supposed to scrub in with Bailey. That was my surgery, Meredith. I can't believe you did this on your first day back. You're like a shark, stealing surgeries out from under me." Izzie was now breathing heavily.

First, Meredith didn't know how to react.

This came out of sudden. She really didn't expect that.

"I ... I didn't steal your surgery. I was on scut, Izzie. Now I am not and that's not my fault. I never asked to scrub in. I asked Bailey to treat me as she does every intern around here. But you were slacking, I wasn't. So I got in. Deal with it, Iz." Meredith replied as she scrubbed herself sterile. "I just can't believe you. Why would you do this to me? This is revenge, isn't it?" Meredith's eyes stared coldly into Izzie's. She could take harsh comments, she could but at some point even that was enough. She won't stand there being used as a punching bag for something that wasn't even her fault. It was alone Izzie's fault that she didn't think of checking the patient's labs and do the pre - operative care which Meredith had done.

The patient was positioned prone i.e. face down on the operating room table.

"Ah, there you are, Grey. We almost started without you." Bailey looked at her with a furrowed brow. Meredith lowered her gaze and apologized quickly: "I am sorry, this won't happen again. Stevens and I just had a little shouting match in the scrub room. She thinks I stole her surgery." Bailey didn't answer.

Instead of that, she started asking questions about the procedure.

A curved incision is made on the side of the gland to be removed, muscles are moved out of the way with retractors and a part of the lowest, the 12th rib may be removed. "This technique does have some limitations. For example, it does not allow as wide or complete a view as the anterior approach, making it less than ideal for larger tumors. In addition, it is harder to remove surrounding organs that the tumor may have grown into in cases of cancer. As a result, this approach is generally not used for tumors bigger than 6cm and those suspected to be malignant (cancerous) in which the removal of additional organs may be required." Meredith answered Bailey's questions.

"Good." She said, her eyes still on the field.

Open adrenal surgery can be done through three types of approaches: anterior, posterior, and thoracoabdominal.

"An adrenalectomy is a surgical procedure where one or both (bilateral adrenalectomy) adrenal glands. are removed. An adrenalectomy can be performed using an open incision or laparoscopic technique. The adrenal glands are endocrine glands located above the kidneys. An adrenalectomy is generally performed to remove benign or malignant tumors of the adrenal glands. Some oversecrete hormones such as cortisol or aldosterone causing severe hormonal imbalances. If both adrenal glands are removed, patients must take steroid supplements of cortisone and hydrocortisone." Meredith answered Dr. Bailey's questions as she held the retractor. Both they had vision of both of the kidneys and the adrenal glands. They also saw the mass on the right adrenal gland which was the reason for doing the procedure at all.

"Would you like to do the honours, Grey?" Bailey asked at the end of the procedure.

"Yeah, I'd love to."

This is a opportunity an intern rarely gets. "You aren't ..." Meredith asked, knowing Izzie was probably in the gallery watching the procedure. "No, I am not. Now, here you go."

Bailey handed her the scalpel and with precise moves she dissected the mass from the adrenal gland. Since the tumor wasn't malignant (they did a biopsy before and sent it to the lab to get more information about this tumor after they had ruled out pheochromocytoma. Luckily for the patient, they discovered that the mass was benign.) Then she had the tumor. It was small but it was there and it had an effect on the endocrinology system.

"So much for me not scrubbing in on any surgical procedures today." Meredith said dryly.

"You've earned it, Grey. You've seen this little detail on the labs that Stevens obviously missed." Bailey replied before she left the scrub room, leaving a widely smiling Meredith behind. Meredith was leaning with her back against the sink. She didn't think her first day back would be such a success. But it was. And that was more than great. She enjoyed being back in the OR for real. It had been an amazing feeling to be back in the OR, to feel the magic that occurs when you hold a life in your hands. That was an amazingly great feeling.

Then, she made her way to find Derek. Hopefully, he would get an office some day. But she could check the OR board. Maybe he was doing some amazing procedure she's never seen before. The surgery she'd scrubbed in was amazing and very interesting. Meredith never had seen an adrenalectomy before, at least not for real, only on the surgery tapes from her mother. There she had seen this procedure. But now she had assisted on an open adrenalectomy. She needed to tell Derek about her success. He was her soon to be husband and she wants to tell him about her surgery. But soon she discovered that he was in the OR, operating on an thirty one - year - old biker who had crashed his motorcycle and suffered from an subdural bleed which he had evacuate in a surgery. Meredith sighed loudly, sh really wanted to share her success with him.

By the OR board she met Cristina staring at it. "Hey, Cristina." Meredith called out.

"Meredith. How are ya doing?" Cristina asked. "I remember my first day after I had one of my fallopian tubes removed, the incision did hurt then." Meredith eyed her for a second then she shook her head. "My incision's fine. I scrubbed in on an adrenalectomy with Dr. Bailey." She said then, smirking. "_What_, you did scrub in on a procedure?" Cristina exclaimed loudly. A few nurses at the nurses station looked their way but Cristina kept ignoring them. "Yeah. Izzie was supposed to scrub in on that but she missed something I didn't miss and so Bailey let me scrub in. I even removed the mass from the adrenal gland. This was so so great, I missed this, I am so glad to be back."

"I can believe that in a second." Cristina laughed.

Then she told Meredith about the heart patient baby she had just saved with a simple fix. "That's great. Hopefully he won't experience such a challenging childhood as I did." Meredith said. "I did my very best wor and Burke watched the whole time. I placed this VSD Occluder myself. _Myself_."

"Okay, now I am kinda jealous. But only a bit. Later Joe's?" Meredith asked.

"Celebrating your day back? Of course, I'm in." Cristina replied. "Sorry but I need to go, need to check on heart patient kid." Cristina Yang told her. Meredith stared at her. "Cristina." She scolded her. "What? It's not like I call him that in front of his parents." She shrugged.

"Heart patient kid?! You dubbed your patient 'heart patient kid'? Really, Cristina." Meredith laughed when she heard that.

"We so kicked ass today." Cristina said. Meredith replied with: "Yeah, we both did."

* * *

Meredith looked over to Derek who was standing there, with a smile on his face as he entered the elevator. It has been four days since she's been back. She is more than relieved to be back, to do what she's born to do. Surgery is her legacy, the one thing she and her mother have in common. They both loved being in the OR as the surgeon. Not as a patient. This is what she was born to do. It's what Meredith Grey wanted to do. But she also wanted a family. With Derek Shepherd. They were on a good path to make it work. Her life was better than ever. She was back at work and she's got a private life with not so much drama which isn't always the case in Meredith's life. Her life always consisted of drama. A lot of drama. When Meredith saw him on the elevator she immediately entered the elevator. "Hey, Mer." He said, his face lit up when he saw his soon to be wife. "Derek. Don't you have patients to see?" Meredith asked. "I do. But I'd rather be kissing you in the elevator ..."

"Derek." Meredith's cheeks reddened. Derek hit the emergency stop button and with a jerk, the elevator stopped moving. "So now we're alone." He started kissing her. It was one of their moments in the elevator.

"What? It's not like it's forbidden for me to kiss my fiancé in the elevator. Nobody can tell us that it's not allowed. I mean it just us, no other people." He just shrugged her concerns off. "If you say so." Meredith relented. "I say so." Derek confirmed. But when should we tell people that we, well, when should we tell them about _us_?"

His blue eyes were looking intensively at her. She really loved his eyes. "Wait a bit with telling our friends and colleagues." Meredith answered, leaning to him and kissing him quickly. They were alone in the elevator. "Okay, I won't tell anyone yet. But can I ask why you want to keep it a secret for now?" Meredith looked to the ground. "I just can't, not now. You know, first the cardio thing and now the engagement. I need to ..." She sighed. "Look, I'll them. Just don't tell anyone just now. Okay?" She tried to be reasonable. Derek didn't ask further questions, he knew Meredith would tell him if she wants to tell him. "Izzie is angry with me." Meredith suddenly confessed.

"Why is she?" Derek asked, looking at his gorgeous soon to be wife. "Thinks I stole her surgery even if I didn't. She thinks I am being favored which isn't the case. I told Bailey that I wanted her to treat me as she would any other intern." Meredith answered. "I just don't want to add fuel to the fire. I'll them and Webber and Bailey in a few days. This isn't like the last thing, okay?" Derek nodded. "We'll tell them together." Instead of a reply, Meredith just kissed him. Then there was a slight ding and the elevator doors opened. Meredith and Derek looked at each other caught. "Ups." Derek said. "Seems like we have to get off now." "Yeah." Meredith giggled at they walked out of the elevator.

"Hey, Grey." Mark walked up to them as they stepped out of the elevator. Meredith and Derek noticed a wide smirk on the plastic surgeon's face. "How is my favourite dirty misstress?" He asked. Derek glanced at him for a moment. "Keep your pants on, Derek." Mark said as he noticed his best friend's gaze at him. "I don't want anything from her." Meredith ignored them both, instead listening to their bickering she just answered Mark's question: "I am great. Since I believe he has told you about it ... he did, didn't he?" Mark nodded. Derek had told him about the engagement before it even happened. "He has." Mark confirmed Meredith's suspicions. "Well, that's what I thought. Anyway, I'm good. Does that answer your question?" "It does." Mark nodded. "How about going to Joe's after your shift ends? I mean, we could all use some happiness, we could celebrate your day back." Mark Sloan suggested. "When do you spend your day off with interns?" Meredith asked amused. "Only with the one who's involved with my brother."

"Mark. You aware of the fact that this is my future wife?" Derek interrupted their conversation. Meredith whispered in his ear: "There's only one for me and that's you, so calm down." Mark laughed for a moment then he got serious again"Yeah, Shep, I am definitely aware of that. So what about Joe's now?" He asked. Meredith shrugged. "Sounds good to me, I'll bring Cristina and Alex too. Is that okay?" Meredith looked over to Derek. "He can pay." She said while pointing toward Derek who groaned in response. With that statement the three of them broke down in laughters.

After Meredith, Cristina and Alex finished their shift, they walked over the street to Joe's bar that was on the side of the road. Joe, the barkeeper, looked up when he saw the doctors heading toward the counter. Jo's bar looked the same as always, as it did before. Right now, it wasn't very crowded. The bar was dimly it with some people standing there, drinking beer and eating peanuts. With them was - Meredith, which was a surprise since she hasn't been here in a long time. "Meredith." Joe called out as soon as he recognized her. She looked as always beautiful - he could say that since he didn't have any *feelings* for her since he was gay and has a boyfriend - and Meredith lit up. She had looked forward to doing a little socializing.

And what was a better place for that than Joe's bar where she often spends her evenings after her shift ended and she doesn't have to work the next day. "Joe. Nice to see you. How have things been for you two?" She asked, referring to Joe's and Walter's relationship. "Great, how about you? I've heard a lot of stuff was going on?!" Meredith turned to Cristina and Alex who had already taken their seats, Cristina already ordered the first round of Tequila for them. Meredith and Cristina always "Cristina, Alex. So much for that." "She might have spilled some secrets when she got drunk out of worry for you." Alex bluntly replied. "She was a fricking mess while they discovered that they needed to put you back on the vent."

"Alex." Cristina scolded him. "Shut your stupid ..."

"Oh, someone gets about getting mad." He mocked her. Meredith just ignored them, she turned to Joe.

"Just ignore them." She said.

"Haven't had anything other in mind. Tequila as always?" He asked. "Yeah. Sure." Meredith responded. She watched Joe mixing the drink and then he put it on the counter. "Thanks, Joe." In this moment, the door opened and causing Meredith and the others to look up. Then two men came in ...

* * *

_**A/N: I wanted to end this chapter on a happy remark since the first paragraphs got a little dark and twisty. But I think the last sentence isn't really a nice ending ... Who knows who they are and what they want ... Hope you liked it. Please review.  
**_


	32. Chapter 32

**Chapter 32**

* * *

**In the practice of medicine, change is inevitable. New surgical techniques are created. Procedures are updated. Levels of expertise increase. Innovation is everything. Nothing remains the same for long. We either adapt to change, or we get left behind. Change, we don't like it. We fear it but we can't stop it from coming. We either adapt to change or we get left behind. It hurts to grow. Anybody who tells you it doesn't is lying. But here's the truth: sometimes the more things change, the more they stay the same. And sometimes, oh, sometimes change is good. Sometimes change is everything.** A Change Is Gonna Come; Meredith Grey

* * *

And what was a better place for that than Joe's bar where she often spends her evenings after her shift ended and she doesn't have to work the next day. "Joe. Nice to see you. How have things been for you two?" She asked, referring to Joe's and Walter's relationship. "Great, how about you? I've heard a lot of stuff was going on?!" Meredith turned to Cristina and Alex who had already taken their seats, Cristina already ordered the first round of Tequila for them. Meredith and Cristina always "Cristina, Alex. So much for that." "She might have spilled some secrets when she got drunk out of worry for you." Alex bluntly replied. "She was a fricking mess while they discovered that they needed to put you back on the vent."

"Alex." Cristina scolded him. "Shut your stupid ..." "Oh, someone gets about getting mad." He mocked her. Meredith just ignored them, she turned to Joe. "Just ignore them." She said.

"Haven't had anything other in mind. Tequila as always?" He asked. "Yeah. Sure." Meredith responded. She watched Joe mixing the drink and then he put it on the counter. "Thanks, Joe." In this moment, the door opened and causing Meredith and the others to look up. Then two men came in ...

Derek was smiling when he saw a small, tiny frame sitting on a bar stool, talking with Cristina Yang and Alex Karev. The bar was as always only dimly lit and now more crowded than it was when Meredith and Cristina and Alex came here. Their shift ended a bit earlier than Derek's shift. Mark was also there. "Look, she's there, with Karev and Yang. Doing funny things, laughing about something apparently very funny." But just that, nothing more. "She is." Derek smiled happily, his heart beating a bit faster when he saw the gorgeous woman sitting there. "Derek's being all McDreamy - ish." Mark couldn't help but mock him when he sees that his brother lights up when he saw Meredith.

"Meredith." He said. Meredith turned around as soon as she heard his voice. "Derek, my knight in shining whatever ..." She looked at him, facing the neurosurgeon. Immediately, he saw that the contact to other people was good for her. Alex and Cristina were good company, apparently.

"So, you're having fun, right?" He asked. "Yep." Came as a reply.

"I'm just a littl' drun'." She mumbled after he appeared next to her. That was somewhere after her fifth shot. "Oh, I see that." Derek said. Meredith nodded wildly: "Yeah, a littl'. Just a little bit." "Yeah, since it's already ..." He looked at his watch. "... after ten o'clock in the evening, we're going home. "No." Meredith whined. "I wanna stay here."

"Come on, Mer." Cristina chimed into the discussion. "Be a good girl and listen to your husband."

She let out a giggle.

"He's not my husband, Cris, he's my fiancé." Meredith corrected her friend with a smirk.

"Doesn't matter. Just listen to him. You can't drive home in your state anyway." Cristina told her. Alex huffed as he listened to their conversation. "It's not like you can. You're just as drunk as she is ..." He pointed at Meredith stumbled against Derek. He catched her before she lost her balance completely. "You really are." He then stated the obvious. "Oh, yeah she is." Cristina added, a little bit slurring. "I am not drunk." Meredith insisted. "A few minutes ago you said you were." Alex shrugged as he said this. "If I can't drive, you can't as well." Meredith crossed her arm over her chest, leaning half against Derek who wasn't very happy with this specific situation that involves three drunk interns. Derek shot Mark a look. What did he get himself into? "Do you know where Burke is?" He finally asked. "There's no way I can let her drive or walk home."

"Yang, you taxi's here." Joe called over the noisiness to Cristina who was drunk as a skunk.

"Wh't?" She looked over to Joe. "I don' need a taxi."

"You sure do." Alex interjected from the side. "You do too." Joe told him. "Give me both of of your keys. You're not driving today." He held his hand out, waiting for Cristina and Alex to give him the keys. "As I said, the taxi's here." He reminded them. Cristina swayed a bit. "Cohome, Alex. Wha' are ya waitin' for?" Cristina was already at the door, holding tightly onto the doorknob, waiting for Alex was walked a bit slower than she did.

When she opened the door, another tall figure entered the bar - just as Cristina wanted to leave.

She stumbled into a man. It was Dr. Preston Burke. She saw it when she looked up. "Cristina." He got out when he saw the curly black hair of his girlfriend. "What is going on?" He then asked, looking around. Seeing a stumbling Meredith leaning against Derek, Alex who was still not giving his keys to Joe who insisted on that ... Everywhere was pure chaos. "Seems like I don't need a taxi anymore." Cristina murmured silently.

"Yeah." Burke said, shocked - obviously.

"They decided to celebrate Mer's first day back -" Derek was the one who finally told him what was going on.

But he was interrupted by a loud, disturbing voice: Cristina. "We both kicked asses today. We needed to have a little fun." She flourished wildly.

"Hm, the fun ends now." Burke was ready to set an end to this whole, weird situation.

"Oooooooooh." Cristina vocalized, long drawn-out.

"Cristina, that's enough. Your little party ends here." Joe watched them amused. Cristina pouted a bit. "But I don't want to go." She had no idea of how childlike she acts. That was oblivious to her. The alcohol in her system prevented her from seeing that.

Derek had other problems at this time.

Meredith insisted on taking Alex home with them so that he wouldn't have to take a taxi.

"Coooomeeee oooon, Derek. Let's take him with us. He won't cause any problems. Also, he the only one who's actually being nice to me besides you and Cristina." Meredith told him in a voice he couldn't resist and she _knew _that.

Derek had managed to get his girlfriend out of the bar without to much problems. He knew she would probably wake up hungover the next morning. But right now she was sleeping in their bed. Derek glanced at the frail sleeping figure next to him before he also lays down and sleeps since he has to work tomorrow. "Goodnight." He whispered as he kissed her softly on the forehead and turned off the lights.

* * *

Derek was already up when the alarm went off. Meredith was still sleeping deeply. He hated to wake her but he kinda had no choice if she doesn't want to be on scut for the following week. "Morning sunshine." Derek called out in a loud voice. Meredith had been sleeping till now. Since she'd been drinking, he was sure she'll experience a bit of a hungover now. And he was right with that presumption. He wondered how Burke was doing with Cristina. Derek pulled away the covers. In response, Meredith only groaned in response. She was obviously hungover.

The light was just so bright and annoying. "Can you keep it down please?" She asked him, trying to get the covers back. But Derek was much stronger than her so she didn't have a chance. "My head hurts like hell." She whined, covering her head with her sheets. "That to be expected after the amounts of Tequila you drank last night." Derek replied, he was making fun of her - at least a bit.

Meredith huffed but never said anything coherent.

"C'mon, rise and shine, Mer. Get up." Derek said, tracing the fingers over the sheets where Meredith was. Her head disappeared under the covers.

"I'm not working." She said her voice muffled 'cause her head was still under the covers. "My shift starts in three hours." Meredith mubled almost inaudibly. Derek looked at the clock radio. "No, actually it starts in thirty minutes. Meaning, you have ten minutes to shower etc. max. So you might wanna hurry." He advised her. Meredith slowly sat up, pulling her hair back and trying to ignore the pounding headache. "Please remind me to never drink alcohol again." She said, grimacing. Derek laughed amused, although he tried to suppressed at which he miserably failed.

Meredith just knew him to good for that matter. She saw it on his face.

"What's so funny about that?" Meredith wanted to know why Derek was laughing.

"You, you're so sweet when you're like this." He said. "I have to shower." Meredith replied. "If you want you can join me." Derek glanced at her. "I can? I am allowed to join you in the shower?"

"Why not?" Meredith shrugged. "If you want, hurry. Bailey's gonna kill me if I am late."

"She won't." Derek said.

"Nah, I wouldn't be so sure about that." Meredith smiled as she undressed herself.

"But I am. She won't ruin all the good work she did. She cares to much to do this." Derek reasoned. "You're talking about what ... Derek, what is it what you're saying?" Meredith stared at him intently. "Not important." He evaded her question knowingly. Of course Meredith figured that much out.

"I don't believe you." Meredith tried to read him. She knows relatively little about what was going on in the week after her surgery 'cause for the most time, she was knocked out. She knows that for a fact, Cristina had told her. "You don't have to." Derek just said, smiling his gorgeous McDreamy smile that seems to work, as always. It always does.

A broad, red line bisected her chest into two. The sternal wires still could be seen. But for Derek that didn't matter. She was the most beautiful woman he'd ever seen - with or without a scar. It didn't matter.

"Oh, you're so sexy with that scar." He mumbled into her ear as they both were standing in the shower, streaming water poured over both of their bodies. He was standing parallel to her. Water solashing over both of them. Time passed, they just had eyes for each other. "I love you, Derek." Meredith murmured against his soft skin as his body was pressed against hers. "I love you too." Derek kissed her cheek. Then the intimate moment was interrupted by looking at the clock. They had to hurry if they wanted to make it on time.

"Crap." Meredith exclaimed and was about to get out of the shower and put some decent clothes on.

"Come on Derek. We have to go." She adressed him and finally he hurried too. They both made it in time.

* * *

"What's going on with her?" Bailey asked, motioning to Grey.

Meredith was sitting on ground, half-leaning against the lockers. She looked tired and kind of had bags under her eyes. Bailey noticed that. "Meredith. Bailey's here, we're getting now." Cristina said, kicking her slightly in the thigh and earning a promptly dissmissing glance. Meredith is now well aware of the fact that she shouldn't drink when she has to work the next day. Maybe it was better not to drink it at all. She tried to ignore her now subsiding headache.

"She's hungover." Cristina replied. Izzie's brows furrowed slightly as she looked over to Meredith who seemed tired. "So what? If she wants to drink it's her problem." She said as she leaves the room.

"She's hungover as well." Meredith pouted.

"Wait, Stevens. Have I said that you could go? I can't remember such a thing." Meredith's eyes darted to Izzie.

Who happened to sense that Meredith was looking at her. Since they weren't getting along all too good, Meredith just kept staring at the ground, avoiding Izzie's gaze. It was weak and she knew it. But she couldn't help. She was weak after all even if all her colleagues, Derek and Cristina would say the opposite.

Except it wasn't true.

If she would have been strong, she would have told them from the beginning.

But she hasn't.

That's a mistake coming from her, she should have them the day her internship started.

She still quarrelled with the fact that hadn't done it right away - "Grey, whatever your in, snap out of it." This was Bailey's voice talking to her. Apparently, they wanted something from her.

"You better listen to her, man." Alex wanted to be supportive. If he was, was another question.

"All of you fools, shut up." Bailey raised her voice. In one fell swoop everything was quiet, all of them were listening to Bailey. They were attentive which was a wonder. Even Meredith made the motion to stand up from the floor and joing the group that was assembled around Dr. Bailey who had their assignments.

"Grey. You're with Shepherd. He requested you as the intern for the day." Bailey started.

Izzie's eyes blinked and she attempted to say something. "Dr. Bailey, it isn't fair ... She always gets the good assignments. She's ..." Meredith couldn't hold herself back, she couldn't just say nothing. "Okay, Izzie. I condoned that kind of behaviour long enough. And it needs to end. I can't take it anymore. I've been nothing but friendly to you. My medical condition does not affect my ability to do my job nor does it give me any benefits. I am just like you, Izzie. **AN INTERN**. Who is here to learn and not to get judged by her colleagues. So just quit being an unbearable ass."

So she had finally told her what is going on.

Izzie fell silent. But her face told them that she still had something she wouldn't say. "If you have a problem with me working with Shepherd take it up with Bailey, she's our resident." Meredith said.

"Can I go now?" She then asked, her head still pounding, she hoped it would soon cease. But she was also excited about potiential neuro cases with Derek, no matter if they involve surgery or not. "Yeah, Grey, go. You've done enough. When you finish your shift I want you go over your post - ops." Miranda told her.

* * *

_**A/N: Hope you had fun reading it. I added some intern drunkiness to it since Joe's Bar is an important piece of Grey's Anatomy that needs to be mentioned. Please review.**_


	33. Chapter 33

**Chapter 33**

* * *

**There's this person in my head. She's brilliant. Capable. She can do chest tubes and craniotomies, she can run a code without freaking out. She's a really good surgeon. Maybe even a great surgeon. She's me. Only so much better. It was a good day. Maybe even a great day. I was a good doctor, even when it was hard, I was the me in my head. There was a moment when I thought I can't do this, I can't do this alone. I close my eyes and imagine myself doing it, and I did, I blocked out the fear, and I did it.** Meredith Grey; The Becoming

* * *

"Grey. You're with Shepherd. He requested you as the intern for the day." Bailey started with the assignments. Meredith was happy that she was on her fiancé's service. Neurosurgery, yay her. It seemed tempting that to jump up and let the others know that she was happy about working with Derek Shepherd but in face to face with Izzie it was better to just shut up. Although her intern colleagues didn't seem very please when they heard Bailey annunciation. But that was okay, she could live with that. She had gotten through much more crappy crap than that. She could handle her intern colleagues. Izzie's eyes blinked and she attempted to say something. Meredith always gets the good cases. This is unfair. She already had stolen her adrenalectomy. Although Meredith hadn't stolen her adrenalectomy, Bailey had let her scrub in on account of a mistake Izzie made. 'Cause she'd screwed up. Not the other way around. But apparently, Izzie didn't see it that way.

"Dr. Bailey, it isn't fair ... She always gets the good assignments. She's ..." Izzie started complaining. But she was at the wrong address with Bailey who wasn't very pleased when she learned that her interns are set off to making her life a bit harder.

"What's not fair, Stevens? The world isn't a fair place, Grey knows that from experience. It's my job to teach you fools and as long I don't think you're capable of handling a difficult neuro patient, it's her patient. You missed something on the labs, Grey figured out. So don't you dare saying Grey stole your surgery. It wasn't your surgery. You don't have to make a scene here." Meredith couldn't hold herself back, she couldn't just say nothing. "Okay, Izzie. I condoned that kind of behaviour long enough. And it needs to end. I can't take it anymore. I've been nothing but friendly to you. My medical condition does not affect my ability to do my job nor does it give me any benefits. I am just like you, Izzie. **AN INTERN**. Who is here to learn and not to get judged by her colleagues. So just quit being an unbearable ass." Meredith finally has the guts to tell Izzie to freakin' back off.

Cristina's mouth began to twitch as she held back a laughter. This was so good. Better than any TV drama. George and Alex were silent as they were watching the interaction between Meredith and Izzie.

Meredith breathed heavily, while glancing at the blonde doctor who kept staring at her with a half - open mouth, bewildered. Even Bailey looked at her, seemingly perplexed. She obvious hadn't expected that from the always so quiet doctor. So she had finally told her what is going on.

Izzie fell silent. But her face told them that she still had something she wouldn't say. "If you have a problem with me working with Shepherd take it up with Bailey, she's our resident." Meredith said concluding.

"Dr. Bailey, can she speak with me this way?" Izzie asked angrily.

"She's right." Bailey shrugged. "I am not your babysitter you have to figure this out for yourselves." Meredith looked to the ground, fearing some speech about how to treat her colleagues. So she decided it was best just to apologize. "I'm sorry for that. But I am not sorry for stating my opinion. We live in a free country and therefore we can state our opinions without getting punished. And mine's valid and not made out of thin air." Meredith said, partly defending herself and her actions.

"Can I go now?" Meredith then asked, her head still pounding, she hoped it would soon cease. But she was also excited about potiential neuro cases with Derek, no matter if they involve surgery or not. "Yeah, Grey, go. You've done enough. When you finish your shift I want you go over your post - ops." Miranda told her. Meredith didn't even tries to object. It was okay. She wanted to be treated as any other intern around here and that involves post - ops. "Will do." Meredith answered. Then she made her way to find Dr. Derek Shepherd. She loved working with Derek. Not only because of him, also she's very interested in his specialty. Hence it's always a joy working with him on some interesting neuro case. Hopefully it will be some interesting case not just a routine surgery. Although routine surgeries can be interesting as well.

She found her fiancé standing at the nurses station, going through some patient charts. On Meredith's face was a smile. The prospect of scrubbing in on some interesting neuro procedure was high. Hippocampectomies, Hemispherectomies, Saggittal sinus bypasses, aneurysm clippings ... "Dr. Shepherd. I'm here, you requested me for a case." Meredith said.

"It's Dr. Shepherd?!" He asked with a charming smile. "Last night it was Derek."

"We're at work and I think it's better if we kept our relationship here strictly professional." Meredith laughed at Derek Shepherd's persistence. "But what about if I want to meet you for some on-call room date?" Derek asked, his blue eyes on landing on Meredith. "Dr. Shepherd, this is highly unprofessional." Meredith said. "So?" Derek smiled at her. "You requested me for a case." Meredith tried to get this conversation back to things concerning work. "Yeah, I did. I thought you might want to join me on this one." He reached for a heavy patient chart, glancing for a slight moment at the patient's name on it and gave it to Meredith. Meredith wanted to open the chart but before she had the chance to do so, Izzie was suddenly standing next to her. Meredith frowned. She hadn't expected Izzie to be on Derek's service as well.

"Dr. Shepherd, Dr. Grey." Izzie Stevens said as she glanced sideways to Meredith who held the patient chart in her hand. She flashed a corny smile at Derek who ignored that. Meredith and Derek exchanged views, not knowing what Izzie was up to. "Mind if I am going to be joining you today?" Izzie Stevens asked exhilarated. She was way to cheerful for Meredith's liking. But what could she do about that really? Nothing. She just has to go with it. Both Meredith and Derek couldn't believe it. "I thought you only requested me ... what is she doing here?" Meredith whispered to Derek who seemed confused as well. He certainly hadn't expected this to be it. He thought Meredith was the intern on this case, he only needs one. Not two or more. But Bailey had other plans - he will soon find out. "Not at all, Stevens." Derek Shepherd told her with a fake smile.

Izzie's face lit up. "Great, so what are we going to do today? Oh please let us scrub in on whatever procedures you've planned for today." Izzie started. Derek wasn't really sure why he has two interns today when he only needs one. Only one and that would be Meredith, not Izzie. "Dr. Stevens, may I interrupt you." His voice showed hints of annoyance. Although he was patient, he had to be patient with these interns. "Yes, of course." Izzie Stevens perkily replied which made Meredith want to gag. But she held herself back. Izzie glanced at the neurosurgeon with big wide eyes. What the heck was her roommate doing?

Did she want to get one over her? But why, she hadn't done anything. Except not being forthright with her health but that was her business and definitely not Izzie's. No it can't be true, Derek thought. What did Dr. Bailey do? Before he could think that thought to an end, he saw Miranda Bailey coming towards him, followed by the other three interns in tow. "Can I talk to you for a second?" "What is it?" He reacted bugged. "Shepherd. I need to talk to you for a second. "Fine." He gave in. Suddenly Bailey was standing behind the trio. "Good." "Wait for me." Derek adressed Meredith and Izzie. He asked them to wait for him, what else should they do? Meredith nodded, although it was barely noticeable but Derek saw the gesture anyway. He and Bailey erased from the group so that they can talk.

"Is it okay if you take them all for the day?" Bailey asked. "I heard you have a hippocampectomy scheduled, these are rare. This is a great teaching opportunity." Yeah, might be. But he didn't say that though. "I only requested Grey, though."Derek made a slight attempt to protest but was silenced by a deathly glare sent by Dr. Bailey. "You're supposed to be teaching them." Bailey said with a voice. He rolled his eyes, already knowing who was winning this. Dr. Bailey, of course. "I know it's my job to teach them but I am the attending and I only requested Meredith, not the whole bunch of them. I have a surgery planned for today. I can't do both teaching and operating, not on this case. This is a touchy case that requires quiet which you don't have if you have to supervise all of them." He motioned to the group of interns. Derek didn't think of giving up but eventually he had to see that this was getting him nowhere.

So he made up a speech to prepare them for the great surgery: "Okay, today you'll see something big. I'll teach you all about hippocampectomies." Derek said, looking at the group of interns standing in a circle around him, listening to what he has to say.

"I could be working on a heart right now." Cristina whispered to Alex.

"Are we boring you, Dr. Yang." Derek asked, glancing at the surgical intern Meredith considered 'her person'.

"Nope." Cristina answered, looking like a deer caught in a headlight. "You can on, Sir." She said, feeling a bit embarrassed, she shouldn't have said that. She knew that now. But now was too late. "You will learn how it is performed. So guys, enjoy this lecture." He said. Then the group of six people (the interns and Dr. Shepherd) entered a hospital room of the hippocampectomy patient. Derek started with greeting Nova, their patient. "Folks, this is Nova Jenkins who's here for Amygdalohippocampectomy." Derek introduced the patient. "Dr. Grey would you mind explaining to her why the procedure is done and what we're going to do?" Derek asked his soon to be - wife to step up. "Yes, Dr. Shepherd. I'd love to." Meredith replied. She is calling him Dr. Shepherd.

"This surgery is ought to stop her recurring seizures." She began. "Yeah. That I hope." The patient interjected. "These seizures aren't really ..." "I can imagine." Meredith smiled at her. When they left the patient room, Derek told them that the surgery was scheduled for 1:31 in the next morning. "But that's tomorrow." Someone complained.

"No complaining." Derek replied. "I just got a ER page. We'll have plenty to do till then."

"That's just great, I thought I'd be on Addison Montgomery's service delivering little babies." Izzie complained. "And I thought I only had one intern but instead of that, I am stuck dealing with all five of you suck-ups. Now hustle, we have a patient in the ER that needs our dear attention." After that, the intern group started following the commands.

* * *

"What do we have?" He asked as he waited with Bailey and the interns for the incoming ambulance. "Multiple trauma. That's all we know." Dr. Bailey answered Dr. Shepherd's question. Meredith and the others were waiting impatiently for the ambulance to pull up. "Hopefully it's big." Someone whispered. "Some bloody trauma so I can get my hands in a body cavity." Cristina looked to Derek and Bailey who were discussing something. "There, it comes." Someone called out. Derek thought it was Meredith but he didn't know. Then the ambulance drove up with howling sirens and stopped with screeching brakes in front of the emergency room. A paramedic jumped out of the car and opened the rear doors. "Joanna Carly, in about 47-year-old woman, right- angle collision with another car, probably internal injuries, already intubated." He told the surgeons in a hectic voice.

"Okay, trauma room 1 is free." The woman's face was covered with blood. "Okay." Bailey muttered to herself.

"Come on, move." There was bustle in the emergency room.

"We bring her up for CT." He was startled, muttered a kind of okay. When they waited for the CT images Meredith looked over to Derek, she was relieved that nobody knew about their engagement and that should stay like this for a while. At least until they had sorted it all out and their relatives … or they have to inform Derek's family. They will want to meet her, that's for sure but will they accept the girl that destroyed his former marriage? Will they? She can't tell them about her medical condition. But they will press for information … But maybe this is the wrong place to freak out now. She would have to talk about that topic with not right now, they had other, more important things to do.

"Meredith, come on. Move." This was Derek's voice that pulled her back to the actual reality. The harsh reality where they had to tend to some huge traumas. "It's a head trauma." Derek said. After the patient was stabilized, she was brought up to make the CT scans. Dr. Shepherd was waiting for the CT scans of her head. Finally, the images appeared on the monitor. He traced the bleeding with his finger. Meredith leaned over his shoulder, trying to catch a glimpse of what could be seen on the screen. "Subdural hemorrhage. She's bleeding into the brain." She muttered to herself. "That's right." After Derek's affirmation, Meredith smiled but then she thought of the patient. "Maybe I should book an OR." She suggested. Dr. Bailey threw the neurosurgeon a look. "Here, a perforation." She then found and attacked the next moment according to the phone and booked a surgery.

"Derek," she tried to attract the attention of Shepherd. Meredith looked at him, waiting for an answer. "Do that, you and Cristina are scrubbing in with me. Now go." He said while Meredith grabbed a phone to contact the OR to get it prepped and ready for them.

Later in the operating room, Meredith and Cristina watched Derek opening a woman's skull. Even though this wasn't heart surgery, it was interesting. But Cristina liked operating on actual hearts. "Yang, what can you tell me about the subdural hematoma?" Yang looked up and answered the question: "A subdural hematoma (SDH) is a collection of blood below the inner layer of the dura but external to the brain and arachnoid membrane. Subdural hematoma is the most common type of traumatic intracranial mass lesion." "Prognosis varies widely depending on size and chronicity of the haemorrhage." Meredith added, although he hadn't asked her but it doesn't matter really.

"That's right, and Meredith, do you want to add something." He said, looking over to her. "And overall 85% of subdural haematomas are unilateral. Common sites for subdural hematomas are frontoparietal convexities and the middle cranial fossa. Like in this patient." Meredith said. "Yeah, like this patient. It's important that these bleeds get evacuated within four hours to prevent them getting worse although small, chronic ones can be observed with serial CT scans. Ah, see, there it is. You see?" He asked, pointing at the bleeder. Both Meredith and Cristina nodded in reply. They saw the bleeding and they watched Derek evacuate it and he let them do small things too. The surgery was a success.

* * *

"Can you even handle twelve or more hours in the OR without gettting any problems or something?" Izzie took a dig at Meredith, glancing at her. She was envious that Meredith had been the one scrubbing in on the emergency craniotomy with Shepherd and Cristina instead of being stuck with doing his post - ops. Meredith shook her head and sighed. This was so Izzie. Why wasn't she getting it. "Why do you even care if I can make it through a twelve or more hour surgery? Why do you even care?" Meredith looked at away, she knew Meredith was right with this one. "You don't." She finished. "And I can push through." Meredith added, anger evident in her voice. Izzie's brows furrowed as she glanced at Meredith for a moment. But she didn't say anything. "I can push through." Meredith said for another time.

"On my first day back, I scrubbed in on a long surgery - and I did it, didn't I?" She said, looking at Izzie. It was a rhetorical question, that was clear. "Yeah, you did and you made it clear so many times didn't you?" Izzie just scoffed in reply. "You think you can do everything. I mean, why are you on neuro since you are supposed to take it easy?" She asked. "I mean, a twelve hour surgery isn't exactly something you'd consider as easy. Sorry but that's my opinion." "That may be your opinion but it's my heart and my health we are talking about and if I know that I can't handle that surgery, I going to say something." Meredith said although she knew there was no reason for that she has to justify herself but she did it anyway even if it wasn't neccessary.

"Well, you never said anything before why should it be different now?" Izzie asked bluntly. "Because now you all now and you look at me with this face ..." She motioned toward Izzie. "... like that and that's just, I hate it. That everyone knows now that I'm sick. Hell, yeah, I am but who cares? It's not like I'm going to infect anybody since you know it's congenital." "I know that by now." Izzie answered back. "Doesn't really look like it." Meredith mumbled silently. "I can watch out for myself, I don't need to be babied by any of you, just so you know."

"Okay, guys. How about we going to the cafeteria to get some food?" George asked, desperately trying to relieve the tension between Meredith and Izzie. He couldn't take it anymore. He was always the on in the middle and he hated that. "Yeah, why not." Meredith agreed, smiling at George for a moment. He had nothing to do with Izzie's sickening attitude. "I'll join you." Cristina called out and jumped up from the gurney and followed them. Even Alex and George were following them.

* * *

"Crap, I'm late." Meredith exclaimed. She had not time for eating or drinking, she just ignored the fact that she was hungry and thirsty 'cause she had a surgery to get to. She can't believe she is late for the surgery she always wanted to scrub in. She ran through the hallways, maybe she could still make it in time. But she was wrong, the surgery had already started. Now that was embarrassing but she couldn't change the fact that she was late. She scrubbed in and then entered the operating room. Instantly, all eyes darted to her, including McDreamy's eyes. Although she shouldn't call him that at work. Derek looked up, seeing Meredith entering his OR. Why was she late?

"How nice of you to finally join us, Dr. Grey." Derek said when Meredith entered his OR after scrubbing in. Meredith knew it was better if she'd apologize for being late and that's what she does. "I am sorry for being. It won't happen again." Meredith apologized, not looking up but staring constantly at the ground. "I hope so, Dr. Grey." Derek replied, his voice sounded as he would speak to any other intern but after a look in his eyes she knew he wasn't angry with her. Meredith ducked her head and quickly stood next to Cristina and Alex. "Why are you late?" Cristina asked in a whisper. "Doesn't matter. Now shut up or do you want him to throw both of us out of the OR?"

"No." Cristina replied. "Then be quiet." Meredith told her. "It's a beautiful day to save lives." Derek said before he picked up the instruments and then he did the first cut. Meredith watched him in awe.

"I'd say the same, Yang." Derek looked up from the surgical area and Izzie's eyes darted to the twisted sisters.

Derek and Meredith wanted to keep their relationship at work strictly professional since they aren't just together anymore. They were so much more than just that - engaged. Engaged and nobody really knew besides Mark and Cristina. But they swore they wouldn't say a word about that thing. It was Meredith's and Derek's news to tell, not theirs.

"Now with this approach, we go straight ..." Derek said. "... down the barrel of the hippocampus."

The interns were listening attentively, they were observing the procedure closely.

Derek was looking through a microscope. He has to be very precise and focused so that he doesn't damage some important area. "Questions?" He asked without turning or looking up. "Does anybody have questions about the procedure?" Suddenly, all interns were talking all at the same time that resulted in a mess no one could understand.

"Stop. Okay, hold it. Let's just slow down." Derek interrupted all the talking. "Here's what we gonna do. I am gonna have each of you take a turn next to me on the microscope." Derek told them. Meredith smiled under her surgical mask. This was going to be a good day. She hoped she would be the first on the microscope but feared that that wouldn't be case since she was late ...

"Whoever is at the microscope, will ask one question." Derek said, his blue eyes twinkling when he looked over to Meredith.

"Yang, you go first." Meredith watched her friend step up and looked what they were doing. This was so interesting. Neuro was interesting. Cristina took a look through the microscope and although brains weren't her thing, this was good, very interesting. She looked into an open brain which was just ... amazing. "This is when visibility gets difficult." Derek explained somewhere in the middle of the procedure. "So why don't we use a self-retaining contractor?" Cristina asked.

Meredith tried to get a better view on what they were doing. Just little peak.

"You can't use it here because this is a keyhole incision." Derek answered. "You risk damaging the anterior choroidal arteries which could result in what?"

Meredith felt her heart skipping a beat, this was her chance and before she knew it she opened her mouth and called out: "Infarction of the internal capsule and the adjacent basal ganglia." Her voice didn't shook a bit as she said this. Derek turned around when he heard her voice and smiled under the surgical mask.

"Yang, step back, Grey, step up." Derek said. Meredith smiled and waited for her person to make room for her. "Man."Cristina mumbled, almost inaudibly. She handed her instrument over to Meredith.

"How can we tell if the patient has suffered a PCA infarct?" He asked, knowing that Meredith knew the answer to that question. "We wouldn't know until after she'd woken up." Was Meredith's prompt reply.

This was starting to be fun.

After Meredith had answered his questions correctly, she earned some glances coming from the other interns who were in the OR as well. "Dr. Grey, step up." Dr. Shepherd said, looking up from the microscope. Meredith smiled a bit, then she stepped up and looked through the microscope. "Wow." She said. Neuro really was her thing. "Yeah, that's really wow." Derek smiled at her, in this moment he couldn't imagine how lucky he got. He was marrying the most amazing woman of the world. This was ...

"Okay, good. And what symptoms would we be looking for with a lesion in this area?" He asked.

"Contralateral hemiplegia, superior quadrantanopia, and amnesia." Meredith answered. This was his Meredith. But since Bailey had told him that this was a teaching hospital.

Then he asked another question and Meredith answered it correctly but since this is a teaching hospital and everyone should learn something he told Meredith to make place for Dr. Stevens. "But I was right." Meredith protested immediately. She had no idea why Derek was doing this to her. She stepped away from the microscope. "Yeah, Mere ... Dr. Grey, you are right. I know that but this is a teaching hospital and you have to let others have a chance too." He explained. Meredith didn't reply. But somehow she was relieved to step back 'cause her incision hurt, maybe she should take it easier than this. Maybe it would be for the better. She stumbled back, finding her balance. "Grey, you're out. Stevens, you're up." "Yay." She exclaimed and taking Meredith's at the microscope.

Derek sighed. So he didn't notice Meredith and the commotion that came up behind him. "Oh, we have a bleeder." He said, looking at the surgical area. "I need visibility in here, Stevens."

Stevens grabbed automatically for the clamp which ermerged to be huge mistake.

"Oh no no no no no, not the clamp." Dr. Shepherd called out and Meredith flinched when he raised his voice although she wasn't the one who made the mistake. "Stevens, what did I say?" Derek called out, trying to be calm but failed.

She may have endangered the patient's life with that action.

Izzie was shocked, frozen. She didn't intend on doing that. Again. "I'm sorry, it's just ... It was just instinct, my hand just went there." She tried to explain.

"Take a step back."

"I'm sorry, is she gonna be okay?" She wanted to know.

"Just quiet, please." Derek demanded, he couldn't work with someone asking questions right now. Izzie stepped back with a pained expression, bumping into Meredith who stumbled a few steps backwards. "Watch out, Barbie." Cristina told in a quiet voice. "Let her, Cris, it's okay." Meredith said although it wasn't really. The room went blurry again.

"Dr. Shepherd." Cristina said. "I said be quiet." She got as a huffed answer. He had other things on his mind right now.

"Before you do anything, wait ..." He said, warning her. Then he got distracted by the voices of Meredith and Cristina. Talking about Meredith.

She knew Alex and Cristina were worried. "I'm okay." She mumbled. "If you say so, Meredith." Cristina said back, watching her. "What is going on over there?" Derek looked up and over to Meredith who tried to shake that feeling off. "Really, Grey? I mean, you don't look good." Alex said. "I am fine." Meredith shot back.

Cristina noticed Meredith's unsteady balance. Worriedly, she watched her person closely to react in case something happened. Meredith was unnaturally pale. Damn it, she should have eaten something before the surgery. But she'd been late already, so she had completely forgotten to eat or drink. So that's how it goes. At least, it wasn't her heart. That was something. Now she got hit by a wave of fuzziness. No, just stand, Meredith thought. But the dizziness didn't go away, as much as she wanted it to go away. "Help." She managed to say before she lost her balance completely, still trying to get a hold of herself but her knees buckle inexorably.

This damn dizzy spell. Why was it happening now? She doesn't want to be a patient again. She hated being the patient. But she felt her legs giving in, Cristina saw that coming and prevented Meredith from hitting the ground. "Come on, sit down." Cristina urged. Then ...


	34. Chapter 34

**Chapter 34**

* * *

**Over the past twenty years, one of the most valuable tools a doctor has is the algorithm. Your patient's main complaint goes into a box and then the formula helps you to decide what to do next. But what happens when the problem doesn't fit into a box? Well, you're suddenly on your own. Unexpectedly, with about a thousand paths to choose from. So what do you do? How do you decide when you're left in the dark? How do you make sure you're not making the worst mistake of someone's life? You close your eyes. You block out everyone and everything around you and you pray that the voice inside you is right. Because once you've decided, you can't ever go back.** Meredith Grey; Change Of Heart

* * *

"We need a gurney in here." Cristina shouted in a panicky mode causing Derek to flinch and look up from the work he was doing, raising his concern for his future wife. The other interns looked up in shock, unable to fully comprehend what was happening. "What is going on?" He asked frantically, still working on someone's brain which means it's important that he stays focused on what he was doing. "We got it here, Shepherd. You just focus on your patient." "I am fine." Meredith insisted. "I don't need a gurney." "Well, in your dreams." Cristina replied ironically, rolling her eyes. Meredith knew there was no way that Cristina would change her mind in that matter. "Where is that gurney I ordered?" "I'd like to remark that she's fully alert and conscious ..." Some medical staff interjected. "I am deciding when she needs help and she needs it ..." Cristina has the last word as always. "I don't." Meredith interjected, trying to raise her voice as she felt Cristina's arms holding her up.

"... right now." "Someone tell me what's going on." Derek was worried about both his patient and Meredith.

"Yang, is she okay?" He demanded answers. But before Cristina had the chance to answer Meredith did it herself. "I'm fine, Derek." Meredith answered his question. "I don't need medical attention, my pacer's working and so is my aortic valve. If that isn't case, I'll come back to you." Meredith was being very insistent on being fine, in no need of medical attention. "See? I knew she can't scrub in on a surgery that is that long." Izzie whispered with disdain for her colleague and it might be safe to say, *former* friend since it wasn't exactly clear what they were at this point and time. "You, shut up." Cristina gritted out, she was enraged about Izzie's cold distanced behavior toward Meredith.

"Calm down, I was just stating …" But Cristina ignored the blonde doctor, focusing instead on Meredith's current condition. Luckily, Meredith was fully conscious. So that was good.

„Meredith, what's going on there?" Derek asked alarmed when he heard the commotion behind him, it seemed tempting for him to just turn around and look what the matter was, what was going on with his fiancé. "You just worry about your patient, Shepherd." Cristina shortly replied, making him nervous. Something was wrong with his Meredith. He saw that when he turned around for a second. Cristina was holding her up, half-sitting half-leaning against her. But she was awake and talking, her circulation just wasn't playing along. He tried to ease his mind telling himself that.

He hopes it's just that and not something serious.

But you never know.

That's the thing about chronic illnesses. You never know what's next. Plus, when thinking of all that's happened he will worry, that's for sure. After all that happened in the last few weeks, the last few weeks that have been a complete nightmare for both of them, he was being overprotective even if it was a seemingly small thing. "And you, you are not fine. I am holding you up without me you'd be lying on the OR floor." Cristina whispered into Meredith's ear. She scowled and closed her eyes in embarrassment.

"I want you do a full work-up, ok?" He ordered without taking his eyes off of the patient.

"I will do that, of course. You just finish up with your patient. I will let you know as soon as I have more information." "Which won't be necessary because I am fine, Derek, I am. I really am. There is nothing wrong with me besides the things you already know about." Meredith interjected, knowing that it wouldn't change things.

But she could at least give it a try.

That won't hurt anyone.

Derek exhaled and inhaled, trying to get his focus back on the patient. He has to try and reverse what Stevens did. He could only hope that that what she did didn't harm the patient in any way since the patient has to be first priority. But his thoughts were circling around the question whether Meredith was okay or not.

He was supposed to worry, that includes the engagement thing. Outside the OR, there was a stretcher waiting for them that they needed to get Meredith to an exam room.

"Will you page Bailey for me, please?" Cristina asked in a voice that let no room for discussion. "Yes, doctor. I will do that right away." The nurse answered quickly, sensing it was urgent. "That would be nice."

"Wait …" Meredith called out.

"You don't need to do this, I am okay. I'd know if I weren't." Meredith tried her best to get out of this situation. Now it was time for Derek to step up. He looked up from behind the microscope and glanced over to Meredith with his intensely blue eyes. "I know I can't make you do this but please, will you at least consider getting another check-up? So I can finish up with my patient without being distracted by worrying over my … over you."

Cristina almost couldn't hide her grin.

She and Mark were the only ones knowing about their engagement. "Fine." Meredith backed down, Derek was acting all dreamy and that brings her out of concept. His dreaminess that seemed to be getting him everything he wanted. His intensely blue shining eyes are fixated on her and on her only, her remembering their unforgettable kisses and the elevator moments. Wasn't it funny that she was thinking about that in such a situation? She couldn't get away from that. It was distracting her from making a point. But in this situation, Derek might have been right. But she just couldn't give him the credit. That would be like showing weakness although she knew that there was no shame in admitting that she needs help.

Help he can't give her 'cause first of all, Dr. Shepherd is a neurosurgeon and currently operating on someone's brain and not a heart surgeon or cardiologist she needed right now. "So I paged Bailey." Cristina told her friend as she assessed her friend's status, trying to get a short overview at Meredith's current condition. Meredith was about to get up from the gurney, seeing it as her circulation stabilized on her own. When Cristina saw what her person was trying to do, she held her down. "You." She said with annoyance with her friend's incapability of following simple orders as a patient and right now she was one even if she didn't like it. "You don't even think about getting off this gurney. You will stay where you or I will physically restrain you. So, better watch out, Mer." Cristina warned her person and that had Meredith calm down. "I hate you right now." She mumbled. "Oh, you love me." Cristina just replied. "That might be true but in a sisterly way." Meredith pouted. "That's what I meant. Don't start twisting the words." Cristina answered. They were waiting for Dr. Bailey in an exam room. "I still think we're squandering valuable time doing this." Meredith hadn't changed her mind one bit.

"We're not squandering anything. We're simply making sure that you're okay 'cause we care about you." Cristina said in a resolute tone that let no room for a discussion. They heard footsteps coming closer but no one of them bothered to turn around to see who it was. "She's right." Bailey interrupted their conversation with a tone that was matching Cristina's.

* * *

Meredith was lying in an exam room, Bailey hovering over her. She was looking over the control - ECG. Meredith was sure it was stress - induced or something, or it was the lack of food in her system. "I am fine." Meredith tried to say. But Bailey just looked at her, frowning. "You just collapsed in Shepherd's OR. Is that your definition of taking it easy?" She scolded her intern. Meredith didn't say anything in reply. There wasn't really something she could say without sounding overly ridiculous.

"There is no way you can be fine." Bailey said for another time.

_She doesn't know that._

"She is right." Cristina agreed with Dr. Bailey ever since there was no way that Meredith could say that for sure. "C'mon Mer, just a quick set of tests, then we're gonna let you outta here." Bailey had the last word, apparently … "I never lost consciousness. I was conscious the whole way through. It's probably 'cause I had no time to eat or hydrate before going into that OR." Meredith argued back.

"I know you never lost consciousness but I am still not taking this lightly. And about the not eating and hydrating thing: you know better, Meredith. That is important especially for you. Then we'll do your labs as well." Meredith groaned in reply. She wasn't able to win this thing. She knew it. "Will you take some of her blood and send it to the lab as soon as possible, Yang?" Bailey ordered her intern to be helpful. Meredith reluctantly agreed to these tests.

"I never passed out." She repeated once again, stubbornly.

"I know you never passed out." Bailey agreed with her, patience was one of her strenghts.

"But let me do this electrocardiogram and then we'll see if there are some pacemaker-induced problems. Maybe there are problems caused by the pacemaker setting. Maybe the pacer is undersensing or oversensing. Or it could be pacemaker tachycardia, tachycardia that is induced of the pacemaker." She said as she connected the leads to the electrodes, Meredith just watched her.

"You forgot the possibility of an exitblock. But that is highly unlikely since it's been weeks since we first placed it which means the battery is supposed last." Cristina added.

"Hello?" Meredith said.

"Would you please stop talking about what could be over the patient? You shouldn't do that. It worries the patient even if there is nothing to worry about. You both should watch your bedside manner." Bailey and Cristina both turned their faces to Meredith, both in shock that she actually had said this. But hey, she's got a point.

"Shouldn't we page Burke?" Cristina asked as she furrowed her brows.

Bailey shook her head, she definitely had this handled.

"I've got this, Burke's in surgery. He won't be out for a few hours which means that we have to manage this." Bailey answered the question of the young doctor. Cristina Yang only nodded in reply. "I'm fine, let me go back to work." Meredith still insisted on being fine and not in need in medical attention. "I am so not letting you go back to work." Bailey stayed hard, she wouldn't budge. "It wouldn't be very responsible." Cristina cracked a small smile when she watched the interaction between Meredith and Miranda Bailey.

"Responsibility, right." Meredith said, she scoffed silently, letting her head fall back onto the gurney.

"Okay, we are doing this, Grey." Bailey said, sitting in front of the machine, waiting for the results. "And try to lay still and not move. You will just make it harder for us to see whether something's going on or not." "Fine. Let's do this." Meredith finally agreed to do those tests. Cristina chuckled slightly.

"Good girl." She said. Meredith shot her an angry, murderous look.

After the three minutes were over and the recording stopped, Meredith sat up again and faced her resident. "You want to do every time I faint or something else comes up, an ECG? Really, every freaking time we're …?" Meredith didn't want to believe it. This was not happening again. "If that is what we have to do in order to be sure that you're alright." Bailey explained her actions. Meredith just shook her head.

"It's a waste of medical resources because there is nothing, absolutely nothing wrong with me in any way. Everything that has been wrong, remotely wrong, has been detected and successfully treated. This can happen in people with congenital heart disease. It does not have to mean that there is something going on with me. It doesn't necessarily have to mean that." Meredith tried to get them to understand it. Dr. Bailey tossed a view at the results, looking over the paper. She was seeing the spike of the pacemaker that was sending the impulses to the heart ventricles. "You're fine? You're not fine, I mean Burke already told you to take it easy but do you ever listen?" She exclaimed. "No." Bailey said, answering the question herself. "No, you don't, you don't listen." Meredith rolled her eyes. This wasn't necessary. She was okay, this wasn't her heart causing the problems. "Bailey, my heart's fine, the pacer's definitely working." Meredith assured her, breathing in deeply. Dr. Bailey looked at her her intern for a moment. "How do you know?" Bailey frowned, waited for an answer.

"I just know. It's my body and know when something's wrong and when everything's just fine even when I just had a dizzy spell. I am okay. This can happen in people with congenital heart defects even if they're medically speaking as well are as they can be." Meredith told her. "This isn't something that endangers my health. It's part of the whole thing." She was trying to convince Bailey to let her go back to work. But that was difficult, way more difficult than she imagined.

Finally, the general surgeon caved.

"Okay, you will let you go but only under one condition." Bailey said, looking at Meredith.

But before she could say anything ... she was interrupted by the opening of the door. Derek came as soon as he finished his surgery. And now he was there, probably expecting some bad news. In this moment, a very worried Derek stormed into the exam room.

He was breathing heavily, he'd just checked on his patient who was stable before coming here, needing to see whether Mer was okay.

"How is she? Is she okay? What happened?" Derek tried catching his breath after firing one question after another.

Meredith knew by the look of his face that he was really freaking out about what happened in this OR.

"Quit the ninety - nine questions, Derek. I am fine." Meredith was quick to answer. Derek didn't seem very sure about that, his gaze went over to Dr. Bailey who knew she was going to say something that goes with Meredith's answer, simply because Meredith for one was right in saying she was okay and Bailey was glad that her intern was right this time.

"She's okay. She should remember taking breaks if necessary and remember to eat and drink. That might have been the cause of this. We're still waiting for the lab results to come back." Bailey tried her best to assure him. "Really, I mean, she collapsed in my OR. I am allowed to worry about her frail health." Derek breathed in, looking over to Meredith. She seemed okay.

"Say that word again and you're dead." Meredith mouthed.

Derek just smiled at her.

_I am going to kill you._

She thought. This was not funny. Both surgeons looked around and faced Meredith who glanced at them.

"I am okay." She disconnected her leads and the monitor flatlined after she did that. Meredith quickly pressed a button and shut the monitor off and the sound stopped abruptly only to be met by silence.

„At least she is not saying that she is fine which she usually does in situations like this." Bailey said with a wry, half-hearted smile as she turned to Derek, it sounded like it was sarcastic.

Meredith just huffed in reply and crossed her arms over the chest.

"Yeah, well that's something, I'd say." Derek replied.

Meredith scrunched her nose at Derek and looked away. Derek walked over to Meredith, looking at her dreamily. In that moment, Cristina opened the door. "I have her labs. Morons from the labs couldn't hurry so I waited hours to get this thing." She was exaggerating. "Let me see." Dr. Shepherd demanded and grabbed the piece of paper out of Yang's hands. "Derek." Meredith scolded. He breathed a sigh of relief. Labs have come back clean.

"You'll be okay." He whispered into his soon to be wife's ear and planted a short but loving kiss on her forehead.

"We'll leave you two alone." Miranda Bailey felt that the two of them had the need to talk about certain things. "Don't forget your patient. She's still in post anesthesia care unit. I will have the nurses page you when she is ready to get moved to her old room." Bailey reminded him.

"Yep, I'll be ready."

"And as for you, Grey. You won't be seeing the inside of an OR this day. Are we clear? But you're free to go now." Meredith nodded and with that Bailey looked at her with her infamous Bailey face that was sometimes very intimidating. "But I can still work in the pit, can I?"

"Would it be wrong to say 'no' to that as well considering you have your intern exam coming up? Studying might be a better option I'd say. But that's up to you, Grey." Bailey said.

"I've been studying the last weeks. I had a lot of free time and Derek was there too, he helped me learn for this test. I am ready to pass it with flying colors." Meredith couldn't help but add that. Bailey huffed in reply but never replied anything. She just left the room. "Yeah, I really did help you study. You're gonna pass this test and you're gonna pass it hard." Meredith laughed. "Will you help me down?" She asked her soon to be husband. Derek chuckled and without saying anything else he helped her down.

* * *

"So let's go see your patient. And then you know I'll make my way to the pit. Super fun. But let's go." Meredith and Derek walked over to their patient's room, after making a quick stop in the locker room where the other interns where sitting on the benches, sleepwalking – looking as if they were half awake and half sleeping. Meredith appeared behind Derek and walked into the locker room, searching her locker for a bottle of sparkling water.

"What are you guys doing? Aren't you supposed to be working? Rounds, five seconds."

Derek made an announcement as soon as he stepped into the locker room. He looked into the faces of Bailey's intern group. Some of them looked at him confused since it was normally Bailey who rounded with them. But right now, it was Shepherd taking on that part.

They all looked equally tired since they've all pulled an all-nighter. That was the fun part of the job, seeing their exhausted features. "Come on, Blondie. Rounds." Alex said as he stood up, obviously wanting to mock Izzie. "Just shut it, Evilspawn. Just shut it." Izzie Stevens glanced up, she knew she was in trouble for what that has happened in that operating room and with that patient. She desperately hoped the patient, a young girl, would be okay and that her brain wouldn't be permanently damaged from what she did.

"Yeah, just pretend I don't know you." Meredith ignored the others.

Cristina scooted over to Meredith, while looking at her questioningly. Meredith felt her gaze linger on her.

"I am okay. Bailey said I am free to go, I can even work in the pit." Meredith told her. "When does your shift end?" Cristina asked. "Not for another four hours and I am ready to end it all." Meredith said, sarcasm visible in her voice. Cristina frowned, but she knew that Meredith wasn't meaning it.

"As some of you may remember the surgery you scrubbed in hours ago, I am now going to check on your patient. She is now in neuro ICU. Now, will you please follow me?" Derek turned around, his white lab coat and the way he behaved only intensified their respect for the neurosurgeon god.

Alex Karev, Meredith Grey, Cristina Yang and Izzie Stevens made their way to the patient's room.

It was the one at the end of the floor.

Richard walks into the hospital to see O'Malley sleeping. He wakes George and said: "We have on-call rooms for that. How did the all night surgery with Shepherd go?" He asks George about his all-night surgery with Derek. George ran off as soon as Richard woke him up, obviously panicked. He missed the whole surgery due to falling asleep in a trauma room. In neuro ICU, Derek is trying to wake Nova, who isn't responding.

"Nova?" Derek asked loudly. "Nova."

The other interns were silent.

"If you hear me can you blink?" He asked. "Is everything okay? Why isn't she answering?"

Her friend, Chelsea was also worried about it which was totally understandable.

Then ...

"Does ... this work too or is the blinking ... medically ... necessary? I can ... absolutely blink, it's ... really no ... problem." Nova slowly got out, opening her eyes. Derek's face showed that everything was in a green range. "She's okay." Izzie breathed a sigh of relief. The 'what if', the not knowing whether she had done something that might have ended in her patient suffering from brain damage had killed her. Eventually, Nova responded weakly. Izzie looked relieved that she finally responded.

Dr. Derek Shepherd ordered: "Stevens will monitor Nova, but you should rest now."

"That sounds good to me." Nova smiled weakly but ready to close her eyes.

Meredith felt sympathy for her, she remembered only all too good how she felt right after her surgery. But she knew that that kind of emotion don't have to have place in her job, distancing herself from her patients was a part of it. "I want you to do hourly neuro exams and inform me if there are changes." Derek said, his words were harsh and distanced. When they left the room, some tears were falling down Izzie's cheek and Derek noticed. In the hallway, Derek told Izzie that they don't cry in hallways.

"Stevens, doctors don't cry in hallways. We have stairwells for that." Izzie is relieved.

"I'm sorry. I am just so relieved." Derek says she got lucky.

Nothing bad happened, but it could have.

If it had, it would have been on her. He says to remember the feeling, the 'what if', not the relief, so she won't make that mistake again. "Yeah, you got lucky today. Nothing bad happened, but it could have. And if it had, it would have been on you. So remember that feeling, that what if, not the relief. It'll keep you from making that mistake again." Derek lectured the blonde doctor, hoping she learnt something from this.

George O'Malley came up and asked what he missed, but Izzie Stevens just walked away.

Leaving a dazzled George in the hallway, not knowing what he had missed.

* * *

Meredith made her way to the emergency room.

On her way to the pit, Alex catched up with her, he was eyeing her before asking: "I wanted to ask how you're doing considering what happened in the OR." Meredith and Alex' relationship was only a platonic one.

"Or maybe I should just shut up about." Alex backpedaled as he felt Meredith stiffen as soon as he asked the question. "That would be for the better." Alex nodded. "Okay, I have to go, I am on Sloan's post-ops and coffee duty. Sometimes plastic surgery really does suck. I'd rather be on peds right now. The attending there actually teaches me." Alex told her. Meredith was only listening with half an ear.

Maybe there was some guy that crashed it motorcycle and wrapped it around a tree.

That would mean surgery. But she knew she wasn't supposed to scrub in on another surgery. "What do you have?" She asked the nurse Tyler who was doing a double shift in the pit.

"Not much. The guy in bed four needs stitches, the patient in bed three has the stomach flu, and then there is another patient that needs sutures. I am afraid that it's all I have, have fun with that." He said rhetorically and left her with a stack of ER charts. Meredith quickly scanned over the charts and sorted out the urgent cases. "My name is Dr. Grey and I am going to suture up that cut. That is a nasty cut you've got there." Meredith said, referring to cut six inches long cut on the man's lower arm while putting on some sterile gloves.

"How did you get it?" She asked, asking for the MOI.

"I fell."

"So, I am going to numb you by injecting an anesthetic so you shouldn't feel anything when I start to suture the cut." Meredith explained while preparing the syringe that has the anesthetic in it. The man scrunched his face after the needle entered his arm.

"Ouch." He said. "That didn't even hurt." Meredith replied dumbfounded.

The man had no idea what pain meant, what more severely injured patients had to endure – much more painful procedures than getting poked with a syringe.

Then she started suturing that cut. Five minutes later, Meredith said: "So I am done here." After Meredith finished up with her patients, she had admitted one of them for overnight observation due dehydration, she saw Derek leaning against the nurses' station. He was probably waiting for her. Meredith quickly walked over to him. "Hey." She said before suppressing a yawn.

But Derek could read her like a book.

"You're tired." He stated.

"I am intern, Interns are supposed to be tired. It's practically my job." Meredith reasoned with a chuckle.

Derek looked at her dreamily and pressed a short kiss on her forehead.

"Not in public, Derek." Meredith silently scolded him although everyone around here knew about their relationship. "Why not? Are you scared that anybody finds out about our relationship that isn't so professional? You're my fiancé, why shouldn't I be allowed to kiss her? She's the most gorgeous person I've ever met." Derek smirked. Meredith suddenly just laughed. It was like all her problems disappeared once she is with Derek. She was feeling free, like she could do anything. "As much as I want to meet you in an on-call room right now, I have patients …" In that moment, the phone rang.

"See? Need to go, answer the phone. No time for dirty calls or whatever you had in mind." "Ah, I see. So, I am off in an hour, we can head home then." Derek suggested.

"I am too. Wait in the lobby, okay?" She didn't wait for Derek's reply. When she answered that phone call, a paramedic on the other end told her: "We've got a seven year old with suspected appendicitis. ETA is five minutes." With that, the call ended. Meredith grabbed her pager and paged Dr. Arizona Robbins for a consult. She was there real quick.

"What do we have?" She asked Meredith as she stepped into the pit. "Seven year old with suspected appendicitis, ambulance is five minutes out."

"You free to scrub in, Grey?" The pediatric surgeon asked her. Meredith nodded although she knew she wasn't supposed to scrub in. Fifteen minutes later, Meredith was standing in the scrub room washing herself sterile and then entering the operating room only to be greeted by Arizona's perky but friendly smile that made her feel welcome in the OR.

"So are you ready to open up, Grey?" Dr. Robbins figured that this would cheer Meredith up noticeably.

Meredith stepped nearer to the OR table.

Another good thing was that Arizona did not ask whether she was okay or not. Maybe she knew that this was not a good idea. Well, she works with teens and children who have heart problems.

The patient already has been put under and was ready to be cut open.

"You bet I am."

The young intern, soon to be Derek's wife and second year resident of Seattle Grace Hospital, smiled under her scrub mask. Arizona saw she was smiling by the way her eyes sparkled. Meredith reached for the scalpel and made the first cut. Right now, she felt like nothing could happen to her, like she was bullet-proof when going into an operating room.

* * *

**Two hours later: **Derek was waiting for Meredith in the hospital lobby.

Meredith exited the elevator, she was talking to Cristina. When she saw Derek, her face lit up and she smiled. "Are you ready to go?" Derek asked as he put an arm around Meredith's shoulders. "Okay, I am going to leave you two alone." Cristina said, grimacing as she watched them interact. But Burke also waited for her to take her home after a long and demanding shift.

"Bye." Meredith said to Cristina and was led to the car. "I know you want to sleep and all but this place is amazing." He said as he sat behind the wheel. "You'll like it." A few minutes later: Meredith and Derek were standing on the deck of a ferryboat. This was their safe place and only theirs. It was cool and windy but sun was shining through the clouds. Meredith and Derek have completed a 36 hour shift in Seattle Grace Hospital. "You're right, this view is amazing." Meredith agreed as she looked over the water. Puget Sound looked so peaceful right now and the coloring was just – there were no words to describe it. "Told you." Derek grinned. "Come here." Meredith cupped his cheeks with her hands and then her lips were on his and they were kissing while enjoying a ferry ride. Ferryboats were _their_ thing. But after they broke the kiss, they went silent. Meredith was the one to break the quiet. Both were tired and all but Meredith wanted them to take a ferry ride to talk about some things they needed to talk about. It was important for her to say this.

"You're all walking on eggshells around me as if you were scared I would break or die. It's really creeping me out. I want it all to be normal. I want feel normal. Like anybody else does. People with congenital heart problems want to be treated as anybody else, for the most part at least. I want to be treated normal." Meredith inhaled deeply, seeking Derek's gaze and holding it.

He just listened to what she has to say.

"I … I understand you're coping with the whole 'me having been born with a CHD' thing but at some point it really has to stop 'cause I don't know how long I can keep doing this will all you being scared or whatever. A certain amount of it is okay, I have nothing against it but if you want me to get examined every time I nearly collapse, then …" Meredith made up a great speech, spilling her feelings over the situation she was in.

"I never was in this kind of a situation before. I never had …" Derek paused.

"… a girlfriend that has congenital heart disease?" Meredith offered, being so kind to complete his sentence. "You could say that. I am a doctor, I know but I just know that I can't lose you. I almost did. You have coded. You could have died and that would have left me with what? A bunch of memories … I want a lifetime. I am talking about a lifetime here." Derek spilled his emotions. Meredith breathed in the sea air. Wind was brushing through her hair and some horn beeped loudly to signal that a big passenger or container ship was coming through. Meredith didn't get distracted by that.

She looked out of the Sound, while talking to Derek.

* * *

**_Flashback_**

_"I think I have read a something in an article about a study that said that bronchoscopic bacteriologic strategy was shown to reduce the short - term mortality risk in patients. Maybe we should try it with Grey, well it cannot hurt." Dr. Burke looked like he considered it. Derek wasn't here. He was resting in some on call room. Bailey and Burke were standing there, discussing about what's best for Meredith Grey. "Maybe we can try it. But first, we need to find the right antibiotics that really work. Multi drug resistance is common in late - onset pneumonia. So it is difficult to treat. I have to go, figure this out. She needs combination therapy using an antipseudomonal cephalosporin, beta lactam, or carbapenem plus an antipseudomonal fluoroquinolone or aminoglycoside plus an agent such as linezolid or vancomycin to cover MRSA. We are going to treat this as aggressively as possible." He said. _

_"What about bronchoscopy?" Bailey intervened, threw in another suggestion of what they could try to help her. _

_"If the antibiotics don't start working, we might consider this but let's see if changing her antibiotics help matters." He said. Derek suddenly was standing there. He came out of nowhere. Suddenly, he was there. "You have to do more than just changing her antibiotics." He told them. _

_"This is Meredith, dammit. She is one of our own, and she is hanging on by a thread. I have the feeling that she's not getting any better, that this isn't getting us anywhere- we need to do more than just giving her some other medication. What about ECMO, it will give her lungs time to heal. Her pulse ox would be significantly higher than now …" He breathed heavily. "Who says changing her meds will have an influence?" Derek sounded desperate. They didn't even know whether it will do something. Maybe it won't even work. They didn't know that._

_ "Derek, I told you to go home." Bailey said, looking at the broken Frame of the neurosurgeon. It was hard to see her colleague and friend like that. "I can't." He said. He looked terrible. He looked like he was going to pass out any second. Bailey slowly cornered him. Derek recoiled but had to stop when he felt the cold, hard wall behind his back. _

_"Derek Christopher Shepherd." She addressed him._

_ "Please tell me that you have gone home to sleep." He shook his head, drew out a deep breath. He didn't look at Bailey. He was afraid of what she might say. Not that it would have changed anything but, well, men and their stupidity._

_ After she sent him to the cafeteria, Mark was babysitting him, she and Dr. Burke continued to look into other options concerning their VIP patient. "Maybe we should look into other options such as ECMO that temporarily replaces her lungs." Bailey suggested, she'd been pondering what Derek has said. Maybe they should look into that before Meredith was desaturating without anything to make it stop. "We're not there yet." Burke said. "If her lung function doesn't improve within the next hours, we'll reassess and maybe put her on extracorporal membrane oxygenation." Bailey nodded in reply and looked over to Meredith's monitor that was constantly monitoring her vitals and blood pressure. _

_Pulse ox was still on 96%._

_Come on, Grey, she thought. You can do this. _

_Only the beeping of the machines could be heard, the whirring of the ventilator, the monotone beeping whenever the leads registered a heartbeat. Her intern looked so small in between all this medical equipment and the thermal blankets. But the setting of the usage percentage of the mechanical vent did not change. Meredith still needed the support and it was clear she wasn't coming off of it any time soon. But at least, her heart rhythm stayed stable. Bailey checked her sats again before she left the room._

**_Flashback End_**

"I understand where you coming from. I know it's scary. But always preparing for the worst is not living, Derek. I want us to enjoy our time together, preferably without mentioning my heart defect." Derek let out a chuckle. His thumb softly caressed Meredith's chin as he nodded to signal that he understood what she wanted from him. Derek took this in. He knew Meredith was right.

They needed to change things.

He swallowed hardly, remembering the previous surgery and the hours afterward.

He had been so scared of losing her forever.

They would have never gotten their happy ending. But he wanted to say his piece as well. And so he did and Meredith only listened to what he had to say. "When you suffered from pneumonia after your surgery, I was so scared and terrified, Meredith. It has been hell, not knowing whether the medications would kick in and start working or if they failed. And they almost did fail. You almost died. We talked about putting you on freaking ECMO to give your lungs rest and time to heal." Meredith stared at him in pure shock. She didn't know how to face him after that revelation.

She did not know that. She had no idea.

"You were talking about putting me on ECMO? You were talking about a machine taking over my lung function? Has it really been that bad?" Meredith asked in a small voice. Maybe this was the source of his fears. They needed to get to the bottom of this. They were talking about extracorporal membrane oxygenation?

"Did they do it? Did they put me on ECMO?" Meredith knew she needed to know.

She was still missing important details of what happened while she was out cold. Derek shook his head. "No, they didn't. At some point, your pulse ox stabilized as the antibiotics started working. But, I will never forget this." Meredith saw in his face that it was hard for him to talk about this. "You, lying there lifeless with a vent shoving air into your lungs 'cause you aren't able to do that yourself. And I am trying to …" Meredith looked away, feeling Derek's hand on hers, something like a comforting gesture she appreciated.

"But yeah, I will try for us and me – to move on and just live our lives."

Meredith buried her head in his chest and for a moment, the couple just … was happy. She breathed in his scent. Some people on the ferryboat who were standing on the deck as well might stared at them but they did not care. "I love you so much, Mer." Derek whispered into her soft hair. It smelled like lavender. She'd told him that it was her conditioner. "I do too." Meredith exhaled deeply. She was tired and wanted her bed. But Derek's chest was doing it as well …

it was a perfect ferryboat ride, the weather was typical Seattle.

* * *

Meredith had no idea how they got off the ferryboat.

She barely remembered anything of it. There was a faint memory of Derek's voice, telling her they have to get off but she doesn't remember how she got into the car.

"'m tired." She mumbled sleepily, she was barely able to keep her eyes open for the rest of the drive home. When Derek waited for the traffic light to change to green he watched Meredith who leaned against the window with eyes closed.

When they finally were home, Derek opened the door on her side and said while gently waking her up by shaking her shoulder: "So, since you're that tired, I am honestly considering carrying you into that house and upstairs to our bedroom." Meredith barely responded. She just made some noise he identified as 'Hmpf.' and nothing more. This day had taken its tribute, apparently. But she looked cute when she was asleep. He carried her upstairs, he was lucky that she was a lightweight.

He put her into her pyjamas and when he was ready to go to bed as well, he saw Meredith was sleeping soundly, her tiny frame huddled into a warm blanket.

He smiled and laid down while putting his arms around her. Soon, he was asleep as well.

* * *

_**A/N: I know I haven't updated this fanfiction in ages but I hope you'll read it anyway. **_

_**I might have mentioned a procedure called ECMO. **_**_In intensive care medicine, extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) is an extracorporeal technique of providing both cardiac and respiratory support to patients whose heart and lungs are unable to provide an adequate amount of gas exchange to sustain life._**

**_Next update will be next week, Tuesday, probably. I hope you will leave some reviews. _**

**_They make my day :)))_**


	35. Chapter 35

**Chapter 35**

* * *

**Surgery is a solo act. We step up to the table with a scalpel in our hand and we got it alone. The isolation can start to define you, because even though you're surrounded by a team, what it really comes down to is your training. Your choices. Your wits. Your hands. Your stitch. It comes down to just you. Surgeons are trained to go it alone, to be solo artists. To be mavericks both in and out the OR. But the truth is we are never alone. We stand on the shoulders of those who came before us. We stand side by side with the colleagues who have supported us. Prepared us. For the moment that every surgeon lives for. When it all comes down to your training. Your choices. Your wits. Your hands. Your stitch. When it all comes down to you. **Go It Alone, Meredith Grey

* * *

Meredith Grey awakened when she became conscious of her snoring. It was still dark outside so she laid back after a quick glance on the timer on her nightstand. The red numbers on the screen told her it was really early in the morning about three a.m. Derek was still sleeping, one arm was placed around her. Meredith wasn't tired at all, she got a goodnight's sleep. It appears that Derek did as well. The wax earplugs were working, they successfully kept him from having to hear Meredith snore at night. Meredith found them by coincidence in the convenience store as she went grocery shopping. She told Derek to try them on after she discovered that he always slept on the couch and with the help of the alarm clock, he managed it to run back and forth between the couch in the living room and the bedroom. Meredith tossed around in her side of the bed, she was feeling the warmth coming from Derek. She had no idea what do. She still has an hour before having to get up. After trying to go back to sleep after waking up that early but failing she decided to wake up Derek for some emergency sex. Somehow, she was horny. Some light fluted through the window, otherwise it was dark. Meredith woke Derek up by pinching his nose. The neurosurgeon was awake within seconds due to not being able to breathe through the nose. He was confused, at first he didn't know where he was. He opened his eyes.

They were met with dark.

Meredith chuckled quietly and ran her fingers over Derek's chest.

"A subarachnoid hemorrhage occurs outside the brain and the intracerebral hemorrhage inside the brain, right Dr. Shepherd. I need to know this in case this is in the test paper." Meredith called out.

Derek sat up abruptly as he heard Meredith's voice waking him.

At first, the whole room was a blur but slowly he could make focus of the walls and the window, the bed and all. He yawned. Why was she waking him up in the middle of the night to ask him these questions? He had no idea. "Why are you waking me to answer a question you already know the answer of? It's in the middle of the night, Meredith." Derek told her but never said anything about the question.

When he didn't answer, she poked him with her finger. "Derek, am I right? I need to know this, otherwise I am screwed in the exam." Meredith fiddled with the blanket. Derek ran his hands through his hair, subconsciously. "Mer, first of all you have more knowledge about any neurosurgical procedure or condition as any other intern. You don't need to worry about failing 'cause there is no way you will fail." Derek assured her. "I have seen many interns come and go but none of them had the potential you have. You're going to make an extraordinary surgeon." Meredith didn't seem to hear him though. She laid next to him, staring at the ceiling.

"But we need a contingency plan, Derek. What if I do fail?" Meredith's mind was ponding whether she'll do it and what would be if she failed.

"You can do this. You can do this." He murmured soothingly and eventually, Meredith calmed down, she was feeling Derek's hands massaging her back as well as he could manage with her lying there. "Ah, you're the one who has woken me up." He said, faking an annoyed tone. "I was." Meredith put her head on his chest and felt his heart beating. It was a welcomed sound. "Do you just want to lay there and listen to my heartbeat or do you want to …"

"Let's go." Meredith planted a small kiss on his cheek.

A few minutes: Meredith and Derek were both lying in their bed, wide awake. "You want to go again?" He asked her, panting. Meredith and Derek both smiled 'cause it was so damn good. Then they heard someone shouting and arguing coming from the hallway, Meredith and Derek turned their heads in direction of the hallway.

"This is like high school." Derek mumbled into her hair. "Only worse."

"It's ain't that bad." Meredith countered.

"It kind of is."

"I guess not, Alex and Izzie are up." Meredith said as she heard her roommates bicker about something, there was some loud noise and then a lot of screaming very early in the morning. Meredith sighed but that's what it's like to have roommates that think of the other one as the enemy-

"Oh." Derek said. "What if I push back my shift and try to do the same for you, I could try to clear your schedule as well …" Derek suggested, leaning towards Meredith who tried to suppress a smile, they were happy, they were a happy couple after all was happened to them ... "I could come to the hospital before I go to the airport and we could find an empty on-call room …" Derek smiled at her dreamingly. "I have rounds and oh, not to mention prerounds. Also, I am not using my relationship with you nor my medical condition to get special treatment. We're so not doing this." Meredith replied smiling, not wanting to show him how much she actually liked that idea - even if it wasn't realizable.

"Oh, we're doing this." Derek said, his voice sure about it. "Aw, you know as much as I like that idea, it's just not feasible, Derek. I have work like charting or prepping for a major surgery to do at work and I can't do you too." "Okay, then it's settled, let's could go again …" He was ready to start, when Meredith loudly exclaimed: "No, you are terrible influence, absolutely not." With that she got up, saying with determination in her voice: "We're getting up now." Derek looked at his absolutely hot fiancé. But Derek stayed in their bed, smiling to convince her to come join him … "I know." Meredith said smirking, eyeing that soon to be husband of hers. "Why don't you make yourself useful and make breakfast for us while I get up and dressed." Meredith's eyes sparkled when said that. "Uh." Derek sighed when Meredith threw a pillow at him.

"Well, you would have to be happy with the breakfast health nut Derek organizes. It includes muesli." Derek loved the tortured expression on Meredith's face as she heard the word muesli.

"I thought about pancakes or something." Meredith said. "And I thought about another round of reconnection." Meredith stared at McDreamy baffled. She was at a loss of words.

But his cockiness was one of the things his loved again.

"And you are terrible." Meredith's voice was slightly raised. She threw one of their pillows at him. Derek just laughed in reply, pushing the pillow away from him. "Have fun doing what I told you to do." She mouthed.

"I am gonna go shower." She smiled at him, obviously trying to seduce him. "You're a tease." He shook his head. And it worked. Derek shook his head chuckling while he watched his absolutely gorgeous girlfriend disappear for the bathroom. "I am gonna marry that girl." He said aloud. "I'd kill you had you changed your mind." Meredith reappeared into the bedroom. Derek looked over to her and pulled his shirt over his head. Meredith was still wearing the Dartmouth shirt she looked so sweet in, on and she had a toothbrush in her hand.

"I wasn't second guessing my proposal. The second I saw you in the Bar I knew that this was the girl I wanted to spend the rest of my life with, that this was the girl I want to wake up next to and celebrate Christmas and New Year's Eve, ours birthdays and I want to make memories together. I want you, Meredith. Whatever that included I am open to it – our journey together into the future." Meredith looked at him for a moment.

"That was nice." She stated, a faint smile covering her delicate face.

"With a touch of sappiness. But that's okay I guess." Meredith laughed happily. With Derek she'd finally found the right guy she wanted to settle down with. She was contented, her life was pretty great right now and she didn't want it to change. "And I am ready for it." He added. "You're being sentimental." Meredith said, now trying not to laugh.

"C'mon, Derek, get up. We can't afford being late. I already have missed so much time in the OR …" Meredith semi complained.

"As a doctor but not as a patient." Derek half joked.

"Ass." Meredith countered but giggled in response. While he is the one to prep breakfast when he could have joined Meredith in the shower which was far more appealing than prepping breakfast but he was doing it for Meredith. After a few Minutes Meredith came downstairs. She entered the kitchen, seeing Derek leaning against the sink with his back. "Morning." Meredith murmured as she saw that Derek wasn't the only one in this room. Alex was sitting on a chair, eating breakfast and looked up as he heard Meredith entering the room. "Hey, Grey." He said. "I love you." She told him with a wide smile, unable to contain the happiness about Derek and their future life together. She was now officially bright and shiny, already knowing that it'll annoy her friends.

In this moment, his phone started ringing, interrupting their conversation. "Derek, it's yours." Meredith noted after a quick look at her cell phone's display. "I don't know where I put it." Derek stated helplessly. "Your phone?" Meredith asked back. "Yeah, of course I mean your phone. I mean, you have to find it before the one on the other end is hanging up." Meredith told him, laughing. "Quit laughing or you're going to pay for this." Derek told her, a sparkle in his blue eyes could be seen. "Make me stop." Meredith just ignored the pleadings of the neurosurgeon. "You might want to check the couch cushions for your phone." Derek nodded but instead he walked up to Meredith and started tickling her until she started to beg him to stop. She smiled at him, catching herself thinking, that this was too good to be true. Her husband, the love of her life was finally here and she was having a lot of fun with him being there as her knight in shining whatever, always there saying things to cheer her up when she was ready to just give up. It's unbelievably freeing for both of them to have a few minutes to them before getting called to work. "Ah, found it." Derek said suddenly, holding up his phone that was still ringing loudly. "About damn time, this ringing was getting on my nerves." Izzie entered the kitchen.

"That thing woke me up." She grumbled.

"Coffee?" She asked, only saying the word. Meredith tried her best not to laugh.

"Here." Derek passed her the carafe while answering his phone. "This is Dr. Derek Shepherd." He said his name, then he paused while frowning. Meredith looked at him in confusion. "Mum?" He asked surprised. Meredith's eyes went wide as she heard that and she was fighting the urge to flee. "Is that you?" He asked. Meredith looked at him with big eyes. Meredith couldn't hear what Derek's mother was replying.

"I know. It's just been a whole lot, I had no time to call." Derek said. Pause.

"I know you want to get to know Meredith, I am aware of that but it can't be right now. Meredith has a lot on her plate right now. But yeah, you'll meet her sometime after I talked to her about when and where and the whole thing." Derek stood up and left the room. Now he finally had his privacy without Stevens looking at him.

"I did propose." He said, spilling it.

He knew his mother was dying to know how it went. Considering Meredith hadn't run for the hills, it can't be that bad. "How did it go?" She asked over the phone. "It was … she said 'yes' to marrying me, Mum." He sounded happy, really happy for the first time in his life since everything ... "I am so happy for you, son." She retorted as she congratulated him.

"I want to meet this woman who has saved my son from his lousy marriage."

"You knew I wasn't happy?" Derek asked, shocked, positively shocked. "Yeah, I know you, Derek and that your whole life. You weren't happy in your marriage to Addison. But clearly, this mysterious girl I have never even met has captured your heart and you're you again. So yeah, I want to meet this woman you made my son whole again. So, whatever you do, can we meet her at some point, maybe before the wedding?" Derek breathed in deeply. A single tear was running down his cheeks. His mother approved. This was it. "I'll talk to her about it. But I can't make any promises." Derek warned her.

"She isn't too big with the whole family thing. There is a lot of baggage. A lot of baggage but you know, she is tough and smart and funny. She is the right one."

"That's why I want to meet her." Carolyn wasn't too shy to answer.

"Okay, Mum, thanks for calling. I really have to go. I have a surgery in an hour. Another hospital requested me for a consult."

"Good, then I won't keep you from your work any longer." Meredith knew she had to meet the McFamily as Cristina would say, sometime. But she hadn't expected it to happen this soon. He took a big sip of his coffee. "I just wish you could come with me to work." Meredith said longingly. "Oh, come on it's just a consult." Derek said. "I am aware of that, also I am planning to visit my mother." Meredith bit into her toast. "I haven't been there since before surgery so it's time." Derek nodded, softly nudging her shoulder. "I can come with you." "You have the consult with Mercy West. Why are they even asking for you? Don't they have any neurosurgeons?" Meredith wanted to know.

"Yeah, they have but they aren't as good as me."

"Your ego is too big. I should stop feeding it." Meredith simply retorted. "My ego has exact the right size." Derek gave her a long kiss. Then they parted and Meredith said: "You know, I wish you could stay or I could come with you or something." Derek already opened the door. "I'll be back soon and you know that. I'll see you at Seattle Grace." Derek assured her. "I know, I know." Meredith followed him to the door. Derek smiled his McDreamy smile. "I love you, you know that, right?" Meredith nodded almost imperceptibly and whispered: "I love you too, Derek Shepherd." A wide smile was on his lips. Meredith looked at him as he came nearer and nearer and finally their lips met. Then they kissed.

Then Derek said smiling: "Wait right here. Wait for me. Stay here." "I can't, I have to work and you know that." Meredith playfully slapped him on the arm. "Hey, there is no slapping neurosurgeon gods, Mer." He mocked her.

"Very funny, Derek." Meredith only replied. "Don't do anything risky." She remembered what happened the last time Derek drove somewhere alone. Meredith got ready as well and was on her way to Roseridge Home for Extended Care. She sat in the drivers' seat and started the car.

* * *

Meredith entered Roseridge Home for Extended Care in the city of Seattle. It was cloudy and rainy today, normal weather in Seattle. But she had taken the ferry anyways. Derek was waiting for her in at the dock. She wanted to visit her mother. Derek had offered to accompany her but she'd declined his offer. She hasn't visited Ellis Grey in a long time. She hasn't been there for weeks. To be fair it wasn't her fault. Also, her mother most likely won't even remember her. Chances are she won't. It was hard but she was being strong. When she walked through the entrance, the woman behind the reception counter exclaimed as she saw her: "Dr. Grey. It's good to see you. We haven't seen you here in a long time." Meredith smiled slightly, not wanting to reveal the reason why she did not come to visit her mother in such a long time. She was only smiling to cover the real reason up. The real reason isn't one you could laugh about.

It has been what, maybe two months since she's been there visiting her mother? Meredith had stopped counting a long time ago.

"I know. Personal problems, I'll try to visit more often." Meredith said.

"Where is she?" She then asked. "In her room." The receptionist replied. "How is she?" Meredith asked, already knowing the answer. "Unfortunately she doesn't have a very good day. Maybe a visit of yours can cheer her up." „Somehow I doubt that." Meredith murmured before making her way to her mother's room. Ellis Grey was sitting there while looking out of a window. Her eyes were lost. Meredith entered the room, smiled when she greeted her mother: "Morning, Mom." Ellis turned around.

"Who are you? I don't know you …"

"It's me, Mom, Meredith." Meredith said. For a moment, Ellis looked like she understood but that glimmer of hope vanished only too soon. "I don't have a daughter that old. Meredith's only five years old." Ellis replied. "I am Meredith, Mom. I am not five years old. I am twenty-nine and about to finish internship at Seattle Grace Hospital." Meredith told her, she hoped her mother would remember the name of the hospital. "I am doing my residency there." Ellis obviously relived old times, Meredith figured. And although it did hurt that her mother only remembered her as the five year old version of her, she didn't let on how much. "You did your residency there, mother." Meredith said. "You then attended a general surgery fellowship at the Brigham." Meredith told, hoping she'd remember moving to Boston and working at another hospital. That was around the time Meredith went to first grade. But Meredith didn't know very much that happened there. "Yeah … I … think I remember." Ellis stuttered. Meredith smiled at her.

"I love you, Mom." She said.

"But my shift starts in, like thirty minutes and I have to catch a ride with the ferryboat so I won't be late for rounds." "You grew up." Ellis suddenly said. Meredith stopped and turned around. "I did." She just replied. "What a shame. Being an adult is awful." Meredith came nearer. "But the carousel never stops turning." She then said. Meredith sat down on a chair. She didn't care if she was late. Maybe she could have a real conversation with her mother. She didn't want to miss that opportunity. "It's what you always said." Meredith noted when she thought back to her childhood. Ellis had said these words pretty often.

* * *

"I had a very great morning." Meredith told Cristina in the locker room. She had a weird grin on her face as Cristina noted. "I so did not want to hear that." Cristina replied as she shut her locker with a thud. "What service are you on today?" Cristina asked. "I am Sloan's service, again. All he lets me do is to bring him coffee and muffins." She whined. Meredith laughed. "Poor you. Whenever I get to work with him, he lets me scrub in." Meredith shrugged. He had never really thought about it but she was the only one who ever scrubbed in on a Faringoplasty and a Rhinoplasty. I am working with Montgomery, so I get to work with pregnant women and babies." Meredith told her. "Meredith is joining the gynie brigade. Sweet." Izzie said ironically. Meredith thought it was best to ignore her, the intern walked off to find Addison Montgomery.

"Dr. Grey, I hear you're on my service today? How's life treating you?" Lately, Addison and Meredith have developed some kind of friendship. She was standing over the fact that Derek was with her and that was okay.

Meredith smiled at the neonatal surgeon. "Actually, quite good. Thanks for asking. I am looking forward to working with you, Dr. Montgomery." Addison laughed, even Meredith cracked a small smile as she felt like her life was coming back. Montgomery never asked her about her condition, just about … life in general. That's what puts Meredith at ease. "I bet you're already thinking about what your job today is." Addison began. "Well, there is this couple up on the OB/GYN floor and I want you to do the consult and the ultrasound. Pregnant mother with triplets, here's the chart." Meredith flipped through it. "Another TTTS case?" Meredith asked, she remembered very well the first time she worked with Addison Montgomery. The first time was very memorable considering she showed up in the lobby and introduced herself as Derek's wife.

"Yeah, it looks like it. Now I want you to do the ultrasound and pitch me the results when you're finished." Addison said. "I have two other laboring moms right now and I need to check on the progress. You can do these tests on your own."

"Thanks." Meredith said flabbergasted as she watched Addison walk down the hallway to the delivery rooms.

* * *

_ "Define TTTS." Addison Montgomery questioned Meredith Grey after requesting her as the intern for this case. Meredith simply answered, she knew her stuff: "Twin-Twin Transfusion Syndrome. Conjoined foetal twins." Addison barely looked up from the chart._

_"Connected by?" She asked in a harsh, not very patient voice._

_"Blood vessels in the placenta." Meredith could answer that question as well. Then Addison asked for the meaning of that, what it means for the babies. "Meaning?" She asked shortly. Meredith thought hard but she just couldn't remember what it was. _

_"One twin gets too much blood, the other gets too little, endangering the lives of both. I expect you to know that." Addison told her as they leave the patient room._

* * *

Meredith went to the exam room where the pair waited for the doctor. Meredith silently opened the door and she greeted them. "Are you the doctor?" The mother asked with a scared voice. "One of them, Dr. Montgomery will be coming to discuss your results. I am here to do a quick ultrasound." Meredith skimmed through the chart. "It says here that it's your first pregnancy?" The woman nodded. "It is, we've tried before but it never … you have to save our babies." "Let's just wait for the results." Meredith said. "You've been admitted yesterday evening after fainting at the airport?" Meredith asked to get a view of the patient history and the reason for admission. "Yeah, we were supposed to fly to Maryland, Baltimore. We were visiting family and all. But I am feeling much better now and so is the baby."

Meredith nodded to signal that she had heard what the woman was saying.

"That's because you are resting, that is the reason why your baby's heart stabilized." Meredith turned on the ultrasound and grasped the transducer with her hand and moved the wand over the woman's abdomen after squeezing some gel on the belly. "This is gonna be a bit cold and uncomfortable." Meredith warned them as she flashed a reassuring smile. "You're in good hands." She said to put them on ease.

Then the young intern diverted her attention to the monitor screen.

She saw three beating hearts and she also saw that two of the babies' blood supplies were overlapping. One of the babies developed a fluid collection around his heart. The woman was mirroring the baby's symptoms.

Meredith put the transducer aside, the picture froze in the moment.

In that moment, the woman noticed Meredith's face expression and started panicking.

"Something is wrong, isn't it?" She asked.

"I have to go and talk to Montgomery. I'll be right back." Meredith said before leaving the room with a printed ultrasound picture for showing to Montgomery. She saw the OB/GYN doctor talking to another doctor and ran over to them. It wasn't even a big deal for her. Before the surgery, it would have been a massive deal but right now it was not. "Dr. Montgomery. It's Mrs. Walters' ultrasound. I think you need to see this." Meredith quickly said.

"Slow down, Grey." Addison told her. "Let me see the picture."

"So tell us." The woman wanted to hear the truth, she looked over to Meredith. "Mr. and Mrs. Walters, I'm afraid I am the bearer of bad news." Addison said, she laid the transducer back in holder connected to the ultrasound machine. "Oh my … I knew it." The mother said, her voice was high pitched. Meredith was standing behind Addison and was just watching. She'd been right.

"Two of your triplets are sharing the same blood vessels and circulation system. This baby's heart is pumping too hard because it's not getting the blood it needs." Addison Montgomery tried to explain what she saw on the monitor as she did a repeated ultrasound. She pointed with the finger at the baby's heart and said: "It's getting starved." as a further explanation. The parents were completely overwhelmed by the fact there was something wrong. Then she moved her finger to the other baby's heart. "This heart is failing because it has to pump too much blood. The volume overload is affecting the baby." "Oh my God." The mother exclaimed as simultaneously, the father asked about the third baby his wife was carrying.

"Luckily she does not share the same blood supply so she doesn't seem to be affected." Meredith told them as Addison motioned her answer that question. "And what I'd like to do is operate. Dr. Grey." Addison let Meredith explain what she wanted to do. "Dr. Montgomery wants to try and separate the blood supply with the help of a laser. She is going to go in laparoscopically."

"You want to cut into me?" The scared mother asked, horrified. Meredith nodded.

"Your babies are showing signs of early heart failure. If we wait on the surgery, in 90 % of the cases one or both babies won't survive. I know this is hard to accept but this is the reality. In addition, it could affect the third." Meredith jumped as she received an imperceptible nod from Addison to show that she can say this.

"It could affect the third?" The father asked. Meredith nodded.

"If we do nothing, the third baby could be affected but for now, nothing like that can be seen on the ultrasound. But like said before, Dr. Montgomery can operate and separate the arteries if you give her the go ahead by signing the papers."

"Dr. Montgomery is the best there is. She's the best surgeon you have working on your babies." Meredith assured her. "The surgery, they could die from the surgery, couldn't they?" The mother asked, putting a hand on her pregnant belly to protect them. "That's always a possibility, yes." Dr. Montgomery cut in before Meredith had the chance to answer. "So, should we do the surgery?" The mother asked, completely unsure of what to do. "I'm saying laparoscopic surgery comes with inherent risks. Fetal survival rate is what, fifty percent at best, which is forty percent better than doing nothing." "We'll do the surgery. We want our babies to have the best shot they can possibly have."

"Usually, TTTS is impossible to correct. Unless you're one of a handful surgeons world who know to separate foetal blood vessels. Which, luckily for you, I am." Addison said, smiling shortly.

"We'll schedule the surgery for tomorrow. Dr. Grey will be taking you through pre-op and post-op. If you have any questions at all, please ask Dr. Grey. From what I heard and seen, she's one of the hospital most popular interns." Addison said. Outside the room, she said: "Order a repeat ultrasound and pre-op labs in …" Addison told her. Meredith shortly replied: "Will do."

"Page you when you have the results, Grey." Dr. Montgomery told her.

Meredith was meeting Cristina at the nurses' station. She sat on a chair, a pencil in her hand and reading in a patient's chart. Meredith cleared her throat as she leaned against the counter and that was what Cristina caused to look up. "Meredith, it's you." She said.

"Yep, it's me, Meredith. Why are you so surprised to see me?" Meredith glanced at Cristina. "I thought you were headed into surgery with Montgomery?" "I am but I got a ten minute break before surgery and I thought I'd spent it with you since there is nothing else today. So, have got anything good today?" Meredith asked.

"I'd rather talk about how your wedding plans are."

"Cristina, shut it." Meredith hissed. She didn't want the hospital to find about her engagement to Derek and the upcoming wedding of those two. "Ah, right." Cristina laughed broadly. Meredith frowned. Her friend could be mean sometimes.

"You don't want anybody to know 'cause they already know about your …" She did not end the sentence. "Yep." Meredith just replied. For a moment, she and Cristina were just sitting and standing there in silence. "I want it to be small." Meredith said. Cristina looked up. "Does he know that?" She asked a valid question.

"I never said anything and we never talked about it. But I think he is the guy who goes for a wedding in churchy church. But for me City Hall it is with you and Burke and maybe some of his closest relatives. I don't want any more of the extravaganza. I am not that type a girl." Meredith shrugged. "Let's hope he understands." Cristina remarked bluntly. "You don't think he will?" Meredith wanted to know. Cristina looked up and into Meredith's face. "I don't know. I honestly don't know." Meredith sighed, in this moment her pager beeping interrupted the conversation. "I have to go, see you later." Meredith turned around and walked to her patient's room.

Meredith was staring at the monitor screen. That what she was looking at wasn't good at all. She pressed some buttons, it clicked and all she knew that the woman wouldn't stop talking and Meredith was only focusing on what was in front of her, the monitor that was showing something bad. Meredith feared that they might have to do the surgery now and not later today or tomorrow. "I am sorry, I need to go find Montgomery." "What why, is something wrong?" The patient asked, her breathing rate slightly increasing. "Sh, calm down, it's not good for the babies." Her husband said, trying to calm her. Meredith showed Addison the ultrasound. "See?" She said.

"Bilateral pleural effusion with subQ oedema." Meredith said.

"Can you repeat that? Just in English, please." The woman wanted to know. "We've detected something that looks like heart failure in the twins. The third is still unaffected but we will move the surgery up. Don't be alarmed. Grey, call an OR now." Addison said. Meredith left the room and on her way to Dr. Webber who is in charge of the OR rotation, she met Derek.

* * *

"Hey, beautiful." Derek said as he walked up to her. "How was your consult?" "Ugh, guy arrested before I could get him into surgery." He said. "that's why I am here so early. "Are you making fun of me, Dr. Shepherd?" Meredith intentionally used Derek's last name, to mock him. "A little bit, just a teeny tiny bit." He told her, as they were both chuckling. "Come walk with me, I need to talk to the Chief about needing an OR. Addison has to go in now. Have I already told you that I am on a TTTS case? It's my second time. My first TTTS case I had was when Addison showed up and she requested me for surgery." Derek stared determinedly at the floor. "Hey, you stop staring at the floor. It's no good for your self-confidence." Meredith murmured. "I'm sorry for not telling you." Derek said suddenly. "What are you talking about, is this about Addison showing up? It's in the past, let's just leave it there." Mer assured him quickly, putting a hand on his arm. Meredith didn't want him to feel guilty. After securing the OR, Addison was waiting for her in the hallway. Dr. Webber and Meredith were there, talking.

"Hey, I am sorry to interrupt but I need to know whether you secured the requested OR?"

Webber nodded. "OR 4 is prepped and ready for you to go. Dr. Grey, wait. She'll join you in a minute, Addie." Richard told the OB/GYN. Meredith scoffed lightly, he didn't notice. She had the feeling that he would be acting as her father figure, again.

And as so many times before, Meredith had been correct in her assumption. Meredith turned Richard, then to her fiancé. Derek's face was point blank. He had no idea why Richard wanted to talk to Meredith. "Yes, what can I do for you, Chief?" Meredith asked. "I heard about what yesterday happened in the operating room, Meredith." He began. Meredith looked aside. Then she turned her head back to Richard. "If you're telling me that I am out because I am not …" Meredith had no idea how to put it.

"The thing is, Meredith, you should have told me from the beginning. You've had the legal obligation to inform me about that. It _is _the law, the hospital policy and you've knowingly withheld that important piece of information."

"And you're saying something now?" Meredith asked.

"Maybe you could have said something when

"So I am obliged to tell somebody about my medical condition? I told Cristina, get over it already, she's my person and medical proxy." Meredith said. "If I had said something, maybe you would have given my spot to someone else? I mean there surely good candidates that can replace me. So someone could have my spot? Fine, fire me. Go ahead. There is still the possible spot in … ." Meredith had no idea what she was talking, it was clear that she wasn't thinking rational. Derek nudged her arm softly and said her name.

"Meredith, stop rambling. You're going to make this worse." Derek told her, he gripped her arm slightly.

"Grey." The command in the Chief's voice startled Meredith and snapped her out of whatever state she was in. "Yes, Chief?" Meredith now sounded small and frightened. "With all due respect, these mommy and daddy issues really have been working for me. You looking out for me is not necessary. You're not my father. Just because you slept with my mother it does not make you my father." Meredith told him in strong voice.

"Meredith …" The Chief tried to say.

"I am capable of doing my job and I know you all look at me like I am going to collapse every time I do something more strenuous. I can't change that and it kills me. So I am done. I don't need people looking at me like I am a patient. I am doctor for Pete's sakes. I save lives. And this is not how this is supposed to be. I know you all are worried. But you're not my father, Richard. You are not."

_As much as I wish he was._

Dr. Webber had a straight face.

"I know I am not your father and I am not trying to be your father. But all I am saying is that, if you need it, you can start by working lesser hours before coming back to your normal schedule."

Meredith stared at him for a moment. "Thank you for offering that, I really appreciate your concern but I don't need it. I know how to take care of myself and I don't need to be babied." Meredith said. "I'm sorry, I have a surgery to get to." With that, she left. Derek looked at Richard who really hadn't expected that.

"It's okay." He said he saw Derek's face expression.

"I'll go talk to her." Derek said, wanting to be helpful. "Go for it." Webber said.

Derek ran after Meredith and he was walking next to her, he held her back firmly. "Derek, I need to go ... Addison's waiting for me in surgery." Meredith explained. But Derek did not seem to care about that right now.

"Meredith what did you think you were doing?" Derek asked with a grave-like face expression. "Why did you this, he was just trying to help." "He was acting as my father and not as the Chief he claimed to be. I don't need him to act as my surrogate father 'cause my 'father' was to busy creating another family and leaving before I was even born. I don't need _him_ or _him_."

"Meredith ..." Derek tried again.

"Let me go, I ... have things to do." Reluctantly, Derek let go of her arm. Meredith smiled shortly at him.

"I'll see you later, Derek."

"We're not done talking about this father issue, Meredith." Derek called after her but wasn't sure if she heard him.

* * *

The patient was already intubated when Meredith entered the operating room. Addison was already. "Let's save four lives, shall we? We just go in laparoscopically, Grey, you know that right?" She said and Meredith nodded eagerly in reply. "Yeah, I know." When entering the OR and stepping near the table, Addison said: "Ten blade. Begin with a ten-millimeter incision." She said as she did the first cut. Meredith was watching. "The vasculature is much more complicated than the ultrasound showed." Addison said, a concerned face expression was covering her face. Meredith knew it, she saw it in her eyes. She'd been looking forward to this. "Yeah, I see." Meredith interjected, her eyes were on the monitor, she watched the precise moves Addison made with the trocars. She saw how complex and complicated the vasculature was.

"But you can do it, right?" Meredith asked without taking her eyes off the screen.

"I hope so ..."

"I can if I just …" Addison has barely completed that sentence when the cardiac monitor started to show signs of distress. The mother's temperature has spiked out of sudden. "Temp's spiking. What the heck is happening?" Meredith exclaimed but staying calm under pressure. Meredith and Addie both looked at the monitor, with Addison exclaiming: "She's having a hyperthermic reaction to the anesthetic. Alright, get some ice and cooling blankets."

Meredith listened to what she said and helped to get some ice.

"We need to lower her temp." Meredith stated before running off to help. They needed to get the body temperature under control or it would affect the babies. "Let's start an IV drip of Dantrolene." Addison ordered as she feverishly worked on saving their lives. "I am removing the trocars. We've gotta get her off the table or we lose them all." They were putting ice packs and cooling blankets on her body to get the temp under control and down. Soon, they had her stabilized and worked on closing her up, there was nothing more to do. Addison can't complete the procedure. "You won't follow through with it?" Meredith asked. "It's too risky and dangerous." Addison replied. Meredith sighed.

"Those poor parents are going through hell and back."

Her husband was waiting in the waiting room for news, hoping everything had gone well. When Addison came to inform him how it went, he stood up and waited for her to continue. "Your wife is okay and so are the babies for now. But I wasn't able to complete the procedure and she is too weak to try again." The husband just stared at her before saying: "I need to see her." Addison stayed back. Meredith was monitoring the wife and for now, she was stable.

* * *

Later: Meredith was getting Dr. Montgomery to confirm something she feared. "Addison, you need to come. It's Mrs. Walters." Meredith said, and the neonatal surgeon followed her to her patient's room where she an ultrasound. "Her heart stopped beating." Addison stated after one look.

"The healthy one died? How?" Mr. Walters asked shocked.

Addison only confirmed this. "Tess's body reacted to the anesthesia. Her blood pressure and temperature went critically high, the baby just couldn't take it." Meredith explained. "I'm so sorry." She added. "It's all we wanted. These babies and now … Two of my babies are still fighting. You said to trust in medicine, to trust you. Please you have to help 'em." She released a heartbreakingly desperate plea. "You nearly died a couple of hours ago, Mrs. Walters. You can't take another surgery." Addison told her. "My body can't take losing all of them." Her lip quivered slightly, only Meredith noticed.

"We could use local." Meredith took her attending aside for a moment as she had an idea. "She'd be awake and there is a risk of hemorrhaging. She could have a heart attack, a stroke." Addison noted.

"I know, Dr. Montgomery. But you heard her, she wants them to stay alive and that is the only way."

"It's too dangerous but yeah, if the parents want it I am going to try." After the parents agreed on the second procedure Meredith started with pre-op protocol.

Addison was inserting the trocars into the patient's abdomen. The room was chop-full with doctors and nurses who were there in case something goes wrong. "How are they doing?" Mrs. Walters asked, a nasal cannula was providing extra oxygen. "Good, hang in there, just a little bit longer." Addison told her. Meredith was watched what Addison was doing. "I'm scared." Addison looked up and saw over to Meredith. "It's all going to be okay." Meredith softly said as the monitor beeped loudly. "I need you to look at the monitor, Mrs. Walters, okay? Stay with me. See the connecting vessels?" Meredith asked her gently, pointing at them. Addison now could work without any distractions.

"We're almost there. Laser." She inserted the laser probe into the trocars.

A few seconds later she said: "In place."

Then she did it.

The beeping immediately stopped. The patient asked what happened. Meredith smiled behind her mask. Even Addison did. "I just separated the babies' arteries."

"You did it."

* * *

"So, I finished my shift. I worked under your Ex-wife." Meredith said as she entered the elevator. "Had an interesting case she had let me scrub in on." She told him. "Mer was on the vagina squad." Alex joked. Meredith glared at him which shut him up. Derek laughed and replied: "So did I. I clipped two aneurysms and then I had an emergency craniotomy which was the highlight. It was bloody and complicated but in the end, I successfully completed it." Cristina entered the elevator together with Burke and scoffed lightly. Meredith chose to ignore that.

"I'd be worried about you saying that if you weren't a neurosurgeon." Meredith mocked him.

"Mer!" He smacked her arm slightly.

"I am just stating the truth." Meredith shrugged matter-of-factly. Cristina, who entered the elevator as well, rolled her eyes, she was followed by Izzie, George, Alex, and Burke, even Mark was riding that elevator. It was really crowded in there. Meredith scooted over to Derek. "Oh, it's you." He said, his words were accompanied by a big, dreamy smile. "Guys, I hate to break it to you but this is a public space." Cristina's words cut through the eloquent silence. "You know, kissing in elevators is our specialty, isn't it, Mer?" Derek looked for support through Meredith. "It is." Meredith blinked into Derek's direction. "McDreamy's being McDreamy in all his glory sappiness." Cristina interjected with an eye roll. "Reminiscing the last time he kissed Mer in an elevator. Good ol' times." "Be nice." Burke scolded her lightly. Meredith had to laugh at the exchange between those two.

She was taken by surprise as Derek suddenly kissed her right onto the mouth.

"Which would be now, Yang. The moment where last kissed Meredith in an elevator." Derek directed to Cristina. Mark silently laughed. This was hilarious. He was so glad he came to Seattle. It would have been a shame to miss this. "God, this is making me want to vomit." Cristina groaned. Please, they were kissing in an elevator when not alone. "This is better than television and you don't even have to pay for it." Alex said but nobody heard him.

The elevator of Seattle Grace Hospital is the world's slowest elevator.

Meredith leaned her head on Derek's shoulder, a streak of her hair suddenly fell into her face.

"Get a room." Someone said but Meredith and Derek pretended like they didn't hear anything.

"Wait." Derek said softly, grasping the streak and putting it behind her ears. Then the elevator came to a hold and then there was a loud 'Pling' and the elevator door opened. A certain redhead from OB/GYN entered the elevator.

"Okay, this is awkward." Cristina deadpanned, obviously enjoying the elevator ride. "Shut up." Three persons told her. Suddenly the elevator stopped moving. There was a weird rumble beneath their feet. Meredith gasped when she felt the ground under her feet come to a sudden stop. Due to the sudden motion, Cristina stumbled backwards only to be met by a wall. Burke frowned and asked if she was okay. According to Cristina, she was fine. "I am, there was just this little motion that threw me off my balance." Cristina murmured. "This is probably going to take them hours to repair this." "Why aren't we moving anymore?" Meredith asked as the elevator stopped to rumble.

* * *

_**A/N: Hope you liked it. Please review.**_


	36. Chapter 36

**Chapter 36**

* * *

**When you're little, night time is scary because there are monsters hiding right under the bed. When you get older the monsters are different. Self doubt, loneliness, regret. And though you may be older and wiser, you still find yourself scared of the dark. Sleep. Its the easiest thing to do; you just close your eyes. but for so many of us, sleep seems out of grasp. We want it, but we don't know how to get it. But once we face our demons, face our fears and turn to each other for help, night time isn't so scary because we realize we aren't all alone in the dark.** In The Midnight Hour; Meredith Grey

* * *

"'cause something destroyed this elevator and now we're stuck in here." Cristina said, her voice got louder by the word and more hysteric by the end of the sentence. "This is just great." Cristina whined, voice dripping with sarcasm. "Better you stop whining. We're gonna be a while and I don't have the nerves to be listening to you whine all the time." Alex said to her. "Oh, Evilspawn. You don't say." Cristina back, not in the least affected by his harsh comment. "Hey, how about we all calm down. I think we're gonna be awhile so it's best if you tried not get at each other's throat." Derek's voice sounded calm and collected in this situation. Meredith admired him for it. She was freaking out a little. She and little, confined spaces aren't doing so well. She was focusing on controlling her breathing. In and out. In and out. She leaned her head against Derek's shoulder, searching for comfort.

Derek noticed what was going on.

He softly murmured 'Sh, it's going to be alright, Mer. You're okay.' He ran his hand over her shoulder. After a few minutes, Meredith had calmed down but they were still stuck in here.

"Has anybody got a phone or something? We might wanna try calling someone." Derek suggested.

"McDreamy has spoken." Mark laughed loudly.

Meredith, Addison and Derek were looking at him in disapproval. Izzie chuckled lightly in affection. Meredith only rolled her eyes at that. She knew Izzie was doing this to freak her out. "Mark." Derek hissed warningly. "Guys, seriously, we need to call someone. This is so not the right place or the right time to do this." Burke interjected. "He's right. Richard needs to know that his elevator is stuck and we're trapped inside." Addison was on Derek's side as well. Cristina looked at hers only to discover that her battery has died.

"Crap, mine's dead." She told them. "Here, use mine. It's working although I don't think the reception is very good down here." "Well, trying wouldn't hurt would it?" Derek was optimistic.

"Well, no." Meredith agreed to the neurosurgeon's suggestion.

* * *

"I have something to tell." Thatcher Grey said as his family sat on the kitchen table, summoned. Each had a plate right in front of them, they were about to have dinner. Lexie looked up knowingly. He's finally saying something about his daughter, his third daughter, the one he left for them. She had kept her mouth shut for the time being. But now apparently, he was ready to tell the truth about it. Lexie was relieved about that. The Molly of baby Laura shared a view with her sister. She was living with them until everything was sorted out and Laura and Molly would be ready to move to overseas to an Army base where her husband Eric, who got shipped out, lives. "Where is the formula?" She suddenly asked as Laura began to cry and she remembered that she hasn't been fed yet.

"It's right there at the kitchen counter, Molly." Susan answered the question of her youngest daughter and pointed toward it.

Molly saw on her face that she had no idea what this was about, absolutely no idea. "Ah, got it. Thanks, Mom." She said she fed Laura via bottle. Thatcher cleared his throat, with that he turns the attention back to him and what he will them. "I made a salad and a pot roast." He then said.

"We know that, we can see that." Lexie said, if it wasn't in this situation this might have been funny.

"I made it. We all know you're a lousy cook, Thatch." Susan reached over to his hand and pressed it softly. Well, if she keeps doing that after dad spills his secret-y secret … Lexie shook his head and asked: "Who wants dinner?" "Me." Susan exclaimed, she was elated to spend some quality time with her daughter as long as she was in Seattle. "So, Lexie, tell me how you've been? How is life treating you at Harvard?" She asked. Lexie swallowed down the food before starting to talk. "It's been great, actually. We've been studying a lot for the upcoming exams and then I'll be set for an internship at Massachusetts General Hospital. I'm really looking forward to it." Lexie explained.

"You got the spot at Mass Gen? You've been accepted into the program? How great is that? That's amazing."

Susan smiled proudly.

"This is my daughter, you are making me proud, Lex." She praised her girl. She got up from her chair and hugged Lexie who seemed to be taken by surprise by that.

"Fantastic. Congratulations, Alexandra. I've always known you could do this." Thatcher said his congratulations as well. Molly smiled at her older sister in silence. She gave her an almost imperceptible nod of acknowledging. A few minutes into the dinner, Thatcher stood up. He looked like he wanted to announce something.

"I have to confess something."

He knew he had to tell his family at some point.

"You didn't cheat, did you?" Susan asked nervously as she fumbled with her napkin.

"No, no, no, I didn't. It's nothing like that." Thatcher replied. "I love you, Susan, I would never cheat on you. I promise." He stammered. He knew there was no way back after saying these words. "So what is it?" Susan asked, confusion noticeable in her voice.

"I … have another daughter."

Deathly silence was in the room that put Thatcher more and more at unease. Molly and Lexie both didn't say anything. They stayed quiet. "You have a daughter?" Susan quietly asked. "And you never said anything before?"

"I never said anything, I know. The reason I am talking now …" He was glancing toward his *oldest* daughter.

"… that I met her. My daughter, I met her when she was in the hospital."

"What about a paternity test?" Susan's voice shook visibly. "We did one and the test results clearly showed that Meredith Grey is my daughter." Thatcher revealed part of the truth. "Why did you do the paternity test at all?" Another question. "Dr. Montgomery and Dr. Bailey talked to me about it. Meredith has the same last name as me, and she kind of requested this. Before the surgery, she was the intern on Molly's case. She noticed that you had the same last name as her. At least, that's what they told me. She's a doctor at Seattle Grace Hospital and apparently, she has some medical issues. Fact is that I have a daughter, Meredith Grey." He concluded. There was tension in the room, they all felt it building up. Susan tensed after Thatcher's revelation, and she let go of hand in shock.

Thirty years of marriage and he never said anything.

How could he do this? To her and the kids and his child? What about her? She was also thinking about a little girl growing up without her dad. She should have known this. If she'd known this, she would have pushed him to be a part of her life. Susan didn't know how to react to that revelation. She would have loved to say that they would get over this but she wasn't so sure. It's been thirty years … thirty years in which he could have said something.

"You have a daughter, Thatcher and you haven't told me until now?" Susan screeched in disgust.

Thatcher looked away. Lexie stopped eating, she had no more appetite as she watched her parents fight. Molly looked over to Lexie for a moment. In this moment, Laura woke up from her nap and starting wailing loudly. Immediately, Molly rushed to Laura and soothed her so that she would go back to sleep.

But the loud discussion wasn't doing anything good to the whole situation.

"Susan, please let me explain this to you …" Thatcher tried to say something.

"You know what guys, Lex and I will go for a walk, Laura needs the quiet and you two have the house, you can fight all you want." Molly stayed calm and collected as her mother would normally be but not right now. Right now, Susan Grey was infuriated with her husband's poor decision-making. "Come, Molly, they don't hear you right now, they're too absorbed in their own problems right now." Lexie stood up and walked through the door. She needed to get fresh air. And a walk would do her good. Why couldn't it be just normal? A normal day with her family, that's all she wanted. But her father had done this. He had another daughter who wasn't that lucky as she was. Who didn't grow up with a loving family. But she also didn't wake up and discover one day that her whole life was a lie. Like Lexie. "So …" Molly spoke tentatively. "What are you thinking about this mysterious girl?" She asked. Lexie shrugged. "Honestly?" She asked. "I don't know. It came pretty out of the blue. But what's shocking is that our mother never knew about this." Lexie said as she pushed the stroller with Laura in it.

Laura knew nothing about what happened.

She giggled happily as she played with her stuffed animal. Laura had very light hair in comparison to Lexie whose hair was darker. Laura's hair matched her mother's hair. Her niece was just so adorable.

It pained her that she wasn't around so much to see her grow up. The siblings walked down the street as it began to drizzle.

"It's raining again." Lexie noted as water dropped onto them.

"It's Seattle, Lex. What did you expect? There are only a few sunny days every year. It's the capital of rain coast, some people say." Molly noted. "I lived here, Mol. It just takes a while to get used to it, I mean." Lexie explained.

"I lived a while away, first for college, then med school." She trailed off.

"Sadly, I missed you, Lex. I missed my big sister." "How do you think she is?" Lexie suddenly asked. "Our sister? You're talking about her again?" "What do you mean, again? Aren't interested in meeting her, just to see how she is?" Lexie asked in disbelief. She cared about her unknown sister. She wanted to get to know. "I don't know, Lexie. I like my life as is. But yeah, when she agrees to meet us, I wouldn't say no. But she might say no to all of this. From what I heard she did not grew up as we did."

"Yeah, well it's kind of our father's fault. He left her mother before she born." Lexie told her.

"How do you know?" Molly scrunched her brows as she looked at her sister. "I confronted dad when you were in the hospital. I needed to know." Lexie told her.

Thatcher and Susan were still fighting over what has happened to them. Thatcher could tell that Susan was not happy about this. "You've been hiding this the whole way through our marriage? What about your child, Thatcher? You have a freaking responsibility to her. If hadn't run and maybe sorted this out with your ex-wife your children they could have had an older sister, your child could have grown up having sisters, a family." Susan couldn't believe what she heard. How dare he lying to her all the time they've been married.

He had so many chances to tell her that he left his former wife who was having his child, his _child_.

He could have done things different. How can a father leave alone his own flesh and blood? But apparently, it's possible. "I couldn't stay. She didn't want me to stay, at least I think she didn't. She had Richard. She was cheating on me with him. She was at the hospital non-stop, even when she was supposed to be on maternity leave. The hospital always came first. So I left. I broke up with her, I send her the papers, she signed and I signed and I was out of her life. Yes, she was pregnant at that point, seven months or something but I couldn't stay." He defended himself and his actions.

"Not even for the baby?" Susan called out, exasperated.

Thatcher shook his head.

He knew he had been acting selfish, really selfish and that the baby, Meredith, was the innocent victim here.

* * *

"What did you do?" Bailey asked as looked through the little space between the elevator doors, looking back and forth between those who are trapped in there.

One of the phones had worked and they have been able to phone for help. It stopped in between two floors. "Nothing, we did nothing." They all answered in synchrony. Bailey huffed. Then she turned to two people on the elevator. Meredith guessed she was going to ask Derek what he did to make the elevator stop. "What did you two do?" Bailey picked out Derek and George 'cause they're always on it when it comes to stopping elevators. "Are you going to get us out of here anytime soon?" Meredith wanted to know. "We're working on it." Bailey shortly replied. "Everyone okay down there?" Was her next question.

"Yep." Cristina answered first, followed by the others trapped in this elevator.

"We're all good, just bored out of our minds." "Are we getting out of here anytime soon?" Someone asked again. "Like I said, we're working on it." Meredith turned around to Derek.

"This is all your fault, yours and your obsession for elevators. This is you and your freaking obsession with elevators." Meredith growled. All had wide smiles or smirks on their faces. This was so funny to watch. It was hilarious. Derek took a peek around and saw all choking back a laugher.

"Oh, god." The neurosurgeon murmured to himself.

"This is absolutely downright embarrassing." He looked over at Meredith who was quietly laughing herself.

Luckily, nobody heard him saying that. After a while no one said anything. "Let's play a game." Meredith suddenly suggested. Everyone including Derek was looking at her as if she had lost her mind. But she hadn't. "Meredith, are you really serious with suggesting that?" Cristina asked, frowning. "Everyone says something about themselves, something nobody knows … come on, it is going to be fun." "More like torture." Cristina mumbled. Meredith shot her glance. "Cristina starts." Meredith's eyes twinkled. Derek loved to see her so happy.

"Let's play Truth or Dare. Who wants to start?" Collective groans could be heard from the attendings.

They were all trapped and although maintenance was working on fixing the problem, they'd be stuck in here for the next few hours. George wanted to do something about the boredom that was obvious to everyone that was only remotely observant.

"Meredith wants to start." Cristina exclaimed as she looked at her friend.

"Bite me." She shot back with fake anger in her voice as she forced to volunteer to start. Cristina only grinned. "So go Grey." Mark smirked at his brother's girlfriend. "I never said I wanted to start. Cristina is the one who started this." "This is just great." Izzie's voice sounded muffled as she talked to George. "Mer." Derek softly nudged Meredith's arm. "Oh, really Derek?" Meredith hissed. "You're supposed to be on my side." "You're supposed to be on my side." Alex mimicked. For most of the time he was okay but at some point he landed a dumb remark. "Just do it. It can't be that bad. I'll go next or something." "I am afraid of tarantulas or any kind of spider for that matter. They just freak me out. It's your turn, Cristina. Do you choose truth or dare?" She directed the question to her best friend to seemed to be out to gang up against her for the time being.

Cristina seemed to ponder this question for a moment.

"Dare." She then answered. Meredith grinned sheepishly. She had something in mind that would freak both Derek and Cristina out and probably even Burke. "This is going to be fun." Meredith smiled at her person, then her gaze landed on her soon to be husband.

"Why are you looking at me?" Derek wanted to know. "So you chose dare." She said.

"Yeah, was that a bad idea?" Cristina asked back, getting an uneasy feeling in her stomach that was telling her that she maybe should have chosen truth instead of dare.

"Kiss Derek." "What?" They both sounded equally shocked. "Meredith …" Derek tried to talk her out of it. "Hey, it's a game. And I am with you, so nothing's going to happen except that it's funny. Also, you wanted to go next. You said it. And this is you and Cristina in one." Meredith was pretty amused by the current situation. "Wait, what?" Burke did not like this at all.

"Shepherd is not kissing my girlfriend." He retorted as he glanced at Meredith fiercely.

"Oh come on, don't be a coward, Cristina and as for Burke, I am watching them closely. So you have absolutely nothing to worry about." Meredith assured him, while trying to suppress a giggle. Derek just stared at his soon to be wife in shock and desperation. He couldn't believe it. She was ganging up against him. "You want me to kiss Yang of all people?" Derek sounded horrified as did Cristina and Burke. At least the feeling was mutual. Meredith nodded. "This is part of the whole dare part, Derek. Just go with it." "So you're okay with me kissing other women?" He asked, apparently to wake the jealousy in her. "No, of course not. Derek!" Meredith exclaimed scolding him as she hit him on the arm, slightly.

"Ouch." He rubbed his arm.

"You started it." His soon to be wife looked to the ground.

"So: no kissing other women?" He wanted to be sure that she meant it. Meredith nodded in reply. "… which means I can't kiss Cristina." He landed a success.

He grinned. He gave high five to Cristina who happily returned it this time. "Thank you Derek, for making this so clear for everyone." Cristina replied to Derek's conclusion. Izzie suddenly complained. "People, this is no fun when everyone cops out on the dares."

"I agree." George said with a somewhat high-pitched voice.

* * *

"You really want to do this, Lexie?" Molly asked as Lexie prepared to leave. "Yes, we have an older sister, Mol, I know she's probably not interested in meeting us but I am gonna try and be a sister to her when she lets me. I want to get to know her." Lexie said eagerly.

Molly didn't want to demotivate her older sister but she feared that Meredith wouldn't be very easy to get to know.

"You really are one hundred percent sure about this, Lexie?" Molly raised her voice to get her sister to listen to her. "Molly, I know what I am doing and if she rejects me, then at least I know that I've tried and that that's more than our dad has ever done for her." Lexie was looking at things from her different perspective, probably 'cause she has heard the ugly details. "Why don't we just …" Molly tried. "No, I want to get to know her. I still can't believe it. But yes, I want to meet her and I think I already her. By accident I told her indirectly that I don't even want to meet her. I mean I was hurt and angry and I most certainly wasn't thinking clearly." Lexie said rigorously.

"I want to make this right, I want to try. If she doesn't want, it's on her. Although I can't blame her if she doesn't want anything to do with me." Lexie Grey was walking through those hospital doors. She wanted a chance to talk with her older sister.

She was aware that she probably would yell or something. Her father told her that she didn't take the news very well, that he had chosen Molly and her instead.

But she took a leap of faith and hoped it would work out alright.

When they exited the elevator, Meredith was looking forward to a nice bubble bath with Derek. As they walked through the lobby, Meredith noticed a young woman standing there, maybe two or three years younger than her. She was looking around nervously, as if she was looking for someone. She seemed to wait for someone.

Meredith hasn't really paid attention until she saw that the brunette woman walked over to her.

"Are you Meredith Grey?" She asked as she saw Meredith, Meredith noticed she had a nice and open smile. She was doing the exact things with her hands as Meredith when she was nervous. Meredith noticed that instantaneously. "I am." Meredith said. She knew this woman and she just couldn't place her. She racked her brain to connect the dots but so far she was not very successful. All she knew was that she's seen her before. "I'm Lexie." The brunette woman introduced herself and held out her hand.

This was weird.

Meredith couldn't help but think that she has heard that name before.

_Lexie?! As in Lexie Grey, Thatcher's daughter?  
_

"You're Lexie." Meredith said, repeating her name. Lexie seemed like a nice person from what she could tell. She looked like she wasn't going to give up or let go something. She seemed You look familiar, is it possible that I may have seen you before?" Meredith asked cautiously.

"I'm Lexie Grey. We're sisters, half-sisters technically and I have thought this through and I'd really like to get to know you. I've had these dreams about my big sister ever since I knew that there was someone to meet that is your older sister and … I'm rambling, I'm sorry and I am just super excited and super nervous about meeting you." The brunette woman rambled, her hands did the same thing Meredith does too when she's nervous.

Derek's eyes darted in between the two women. They both ramble. Also, she seemed pretty tenacious on trying. She had this look in her eyes that she wouldn't give up just because it will be difficult! A determined face expression was covering her face.

It's something he instantly noticed.

Meredith looked at her in confusion. What did this girl say about her? That they were sisters?

Lexie.

She remembered the name. Lexie was the one who goes to med school, she was the smart one and she also said that her father was crazy proud about her, Molly had told her when she was on her case when they did the balloon procedure to make sure her baby's lungs develop properly. Her baby has been treated for a diaphragmatic hernia.

She'd been the intern on that case.

Meredith remembered that, she remembered what she told her. That was the first time she suspected that this woman was her sister. When she said she had an older sister, Meredith didn't let on that she suspected that she _two_ sisters. Not only one.

Derek was watching Meredith, he was waiting for her to reply.

But at first, Meredith seemed too shocked to even think about answering. Derek softly nudged her shoulder. "Sister?" She got out. Lexie nodded eagerly. She could read from Meredith's face that she has not expected this. "You're coming to this hospital just to tell me you're my sister?" Meredith asked flabbergasted. This wasn't how she had imagined her evening would go.

"Look, I can see that you try to be nice or something but I've had a long day." Meredith couldn't think of another answer. "For the past hours, I have been stuck in that elevator and I am forward to get home. I am sure you are a person that is easy to like but for me you are the reminder of everything didn't have. I know this sounds like I am a bad person but I am not. I've been just through a lot of crap." Meredith rambled as well, her tired nerves were embarrassing her badly. Lexie glanced at her older sister and scanned her. She was thin, had blonde hair and well, she seemed likeable. But she didn't want to get to know Lexie.

And it hurt her.

She didn't know how much she wanted an older sister until she got told that she wasn't wanted. She figured that Meredith must be feeling the same way about her dad.

"I am sure you are sweet and nice and friendly but I don't have a sister. I'm an only child. You're just not a person I want to know or get to know." Meredith saw that her words hurt Lexie but she just couldn't do it. All she could do was run. Run, her mind screamed at her but her feet were like cement. Derek was talking to her but she wouldn't listen.

Running has always been her first instinct when something like this happens.

"Meredith." Derek said. "At least listen what she has to say."

"I don't have a sister." Meredith had tears in her eyes. "I'm sorry but I don't have siblings." She repeated as she looked over to Lexie.

"It's probably better if I go." Lexie stammered helplessly. Molly had warned her.

Maybe she should have listened instead following her stubbornness. Meredith hated her, or the idea of her. Lexie wanted her sister to like her but she was now walking out of this with tears brimming in her eyes. Why was she being so emotional about this? She did have a good childhood.

* * *

Derek was driving them home. Meredith's head leaned against the headrest and Derek was concentrating on the traffic. It was late. It had taken maintenance hours to repair the elevator. Derek has seen that Meredith had been tired in the end. She had been trying to cover it up but he could read her like a book. "You tired?" Meredith's soft voice sounded through the car. Derek was glancing over to her, he laughed quietly. It wasn't exactly raining but it was drizzly. "It's been a long day. I am a little exhausted, mostly from the elevator." He snickered suppressed. Meredith nodded thoughtful but stayed silent. "You know, Richard, he cares, Meredith." Derek slowly said, cautious. He was aware that this most certainly won't go well with her. Meredith could act a little intense when she was surprised by something like this.

"You want to talk about this now, Derek?" Meredith groaned instantly.

She hoped that it could have waited. He nodded, his fingers were tightly gripping onto the wheel.

"Well, he didn't care when I was a kid. He didn't know, Derek. I would have thought Ellis told him. Maybe she would have told him when he had chosen her … I don't know."

"Did he choose Ellis?" Derek asked, couldn't help but recognize the similarities between the stories, only that he chose Mer in the end. "No, why would he do that? He stayed with Adele who was the safer choice. Let's face it, my mother, nothing wrong with being safe. So he chose Adele although she begged him not to. I saw it, I only remember bits and pieces but I saw it." Meredith elaborated without him asking that much.

"You saw _him_ breaking up with _her_?" Derek asked shocked.

"And I did the same to you. I broke things up with you 'cause it was the right thing to do, trying to work on my marriage. I've been Richard in that scenario. Now I get it." "Two men have chosen others above me." Meredith remarked.

"Don't say it's not true, Derek. I begged you to choose me, pick me, love me and you still went back to her and my father, well more like sperm donor since he was never around to watch me grow up and now had the nerve to show up and act like we could be a family again? Where was he twenty-seven years ago?" Meredith ranted, she didn't admit it but she was hurt by her father's actions. "You have got to stop pushing others away." Derek told her in serious voice. Meredith avoided his gaze. She did not dare to look at him. "Richard … I don't whatever history you two have but if you are being honest, he is the only father you ever had. "I don't have a father, Derek. That is the difference between you and me. At least yours was a dad to you, he did things a dad is supposed to do, I … no one ever took me camping nor taught me how to ride a bike. I did these things on my own. All I had was my mom. And now it's you and Cristina. These are the only persons I have." Meredith said emphatically. Derek sighed, this was getting them nowhere.

He knew from experience that this was a touchy subject for Meredith but at some point she needs to face the truth.

"There is no point in denying that, Meredith. You did the same to the girl in the hospital lobby. She just wanted to talk to you." Derek said as they were standing in the kitchen, for one fighting.

"I know. I know she just wanted to talk but all I could …"

"Meredith, you deserve to have a family. And she is …" Derek tried to get her to listen but for such a tiny woman she could be really stubborn. "She's what, blood-related? That does not make her my sister. I don't have siblings. I am an only child, I grew up that way." Meredith shot back. "You didn't even let me complete me sentence." She told him in a harsh voice.

"What are you saying?" Derek asked confused.

"I did let you complete … didn't I?" He asked.

"No! You cut me off when I was talking about what I was thinking when she confronted me." Meredith bit back. Derek leaned with his back against the sink. Meredith was standing near the kitchen table.

"Would you please hear me out? Then we can go back to fighting all day, I have no problem with that, really."

"It's evening, Mer." He reminded her softly.

Meredith huffed. "I know. Lexie's had a perfect childhood. I mean I don't really know …" Meredith started disparagingly but Derek scowled dismissively. Meredith frowned. She'd seen and registered Derek's reaction. "See, Mer, you don't know. You can't just assume someone had a perfect childhood just because they aren't as screwed up as …" Derek wasn't able to finish the sentence 'cause Meredith interfered.

"… as I am?! Just because I was more dark and twisty during my internship it doesn't mean I am screwed up. Yes, tequila and sleeping around were my coping mechanisms but Derek, I grew up. You proposed. We're getting married. Or are you having second thoughts?" When she said that her voice quivered, in this moment, she was vulnerable, Derek was seeing this. She sounded defeated. Maybe she'd given up hope that the universe would ever let her be happy. The universe was just screwing with her. "No, of course I don't regret my decision to propose, Meredith. It was the best decision in my life and one of the most important ones. I'm as sure as the time I decided I wanted to become a neurosurgeon."

Meredith's eyes were focused on him.

"Which is a lot I hope?" Meredith did not dare to hope in case all comes crashing down on her and leaves her completely destroyed. "Which is like a hundred percent. Just because we're arguing it doesn't mean this will be the end of us." Derek told her reassuringly.

"Good, because I don't want us to end." She said, her voice small and despondent.

Her eyes were a bit watery.

Derek knew all people she ever cared about left at some point. He did, too. When he chose Addison, he left Meredith. Even if they got back together after the bomb scare.

"So you still love me?" Meredith asked, her voice shook a little.

Derek looked at her for long moment, he was taking her features in. "Yes, Meredith, I love you. Married couples, they fight. It's normal. We will fight and then we'll break it up and apologize. Fighting is vital in a relationship as long as there isn't too much fighting." He chuckled lightly. "And this isn't a fight. It's simply a heated discussion." He assured her.

Meredith nodded, now that she knows that he isn't going to break up with her. Her damned issues, she thought. Why was everything like this, every fight they had, she thought he was breaking up with her. Why is she always thinking that?

"It's just that when we fight, I have the feeling as if you're breaking up." "But I'm not." "I … I can't describe it." Meredith whispered, she felt like an complete idiot for thinking that.

"I have abandonment issues, Derek. I need you to promise me you won't just leave."

Derek nodded. "I won't. Scout's honor."

And by any means, you had your fair share of things that had to do with me being that screwed up, Jackass." She mumbled to herself. "Yet here you are calling me a jackass." He accused in disgruntlement. "While I just want you to have a family because you deserve one and that's all you got – I know you're think you're a burden to anyone in your life. Cristina once told me when we were fearing for your life. You have issues, yes but facing them is an important step. Let's start with meeting your half-sisters. I mean they're probably as shocked as you are. But they're trying." "But I am not ready." Meredith argued back. "Uh yeah, when will you be ready? Maybe fifteen years from now?" Derek threw back, he wasn't in a good mood right now.

Meredith wasn't either.

"You're exaggerating. I just need time to process. This is all going way too fast to even notice what's going on. I just started to work, the intern test is in four days, I am way behind in logging time in the OR and then I have all this personal crap going on. Plus, I have a routine appointment with Burke scheduled to control pacer settings next week. There is no time for meeting blood relatives I have nothing in common." Meredith paused, she hated fighting with Derek.

Derek calmed down when he listened to her talking about her appointment with Burke.

"When is it?" He asked.

"When is what?" Meredith played dumb. "When is your appointment with Burke to control your pacemaker setting?" He questioned gently.

"Tuesday, I think." Meredith answered.

"I'll clear my schedule." Derek said after receiving an answer. "You don't have to do this, come with me every time I have a follow-up. I mean that's probably gonna be like all three or four months." "Meredith, you do not need to talk me out of this. I know what I've gotten myself into and I think as long as we're together we'll do this even if you need an ECHO every three or four months. I really don't mind. My schedule's flexible and I love you." He said, he slowly came nearer to Meredith.

"Your choice but Derek, don't tell me afterwards that you're running late and all. That you are running so late that you hope that by some miracle one of your patients is a no-show. That you are way behind your stuff because if you're gonna do this, say it now."

"Meredith, I promise you I won't be an ass." He said.

"Still, I don't know why you won't make peace with Richard." He prodded. Meredith turned her head toward him. "No! I don't need a father figure. I've been fine without one my whole life and guess what, I am still here." Meredith told him, a sad laugh escaped her lips. Derek saw tiredness edged across her face. "Meredith, you don't have to do it tomorrow but at least think about talking to him so you can get on with your life."

"Just stop trying to fix my mistakes, okay? Just leave them." Meredith couldn't take it anymore.

This evening was just tiring and exhausting. With that she turned around and walked upstairs. "I am going to bed. Goodnight." Meredith called down before she laid down on her side of the bed. She pulled up the blankets and crouched beneath them, she was welcomed by immediate warmth spreading through her body and she finally relaxed. Derek heard her going upstairs but he stayed downstairs. He figured that he wasn't the one she wanted to see right now. Coward, a voice in the back of his mind screamed at him. So he quietly walked up the stairs. After changing into his clothes for the nights, he laid down next to her. Meredith didn't budge. This fight totally wreaked havoc with their plans.

He knew Meredith wanted to spend this evening with him but he had ruined it.

"I'm sorry." He whispered as he switched off the light so that they were in the dark.

"Quit it, Derek." Meredith gave back, she wasn't turned to his side. "Do you want to take your mind off it?" He asked cautiously. "No." Meredith answered. "Do you want me to go?" Meredith shook her head. Derek felt an immense relief running through his body.

She wasn't throwing him out. He thought he couldn't sleep but somehow he fell into a dreamless sleep only to wake up to an empty bed. Meredith was still asleep. He wasn't sure if he should wake her up or not. He rubbed his eyes and squinted. He was so tired. It was 5:30. They had to be at work soon. He groaned as he got up and walked into the bathroom.

* * *

In the next morning, Derek was already up when Meredith got up and entered the kitchen. "Good morning." He mumbled sleepily as he took a sip from his coffee. "I didn't want to wake you, you looked so peaceful." Meredith chortled. But besides the sound she didn't say anything, not even a good morning. Derek frowned. He hadn't anticipated that it would be like this. Apparently, he hadn't thought about a lot of things. "So now you don't speak to me?" Derek asked lightly. Meredith didn't react. "Sometimes boyfriends can be jerks but that doesn't mean you stop talking to them. You get that I am saying sorry, right?" He tried for another time.

"I thought you were gone, to the hospital or something, the best was empty when I got up. So I thought …"

"I left." Derek completed. "I have never done this before." Meredith finally admitted as she looked up from the sandwich she was preparing for herself. "You have never done this before." Derek repeated as a light lit up in him. Meredith does not know how the whole fighting thing works. "Ok, this is how it works …" He began as Meredith focused on him. "Go on." She told him as he paused. "You fight sometimes and somebody apologizes." Derek told her, an amused smile was gracing his features but he suppressed it.

He didn't want Meredith to think that he does not take her seriously. He does take her seriously.

"Well, how am I supposed to know that?" Meredith retorted unsurely.

"You've never done this before."

Derek thought for a moment before coming nearer.

"Ok, from now on you can expect that I am gonna show up. Even if I yell. Even if you yell. I am always going to show up. Ok?" He asked, a smile gracing his lips.

"Okay." Meredith agreed. Derek placed a gentle kiss on her lips before pulling her into a hug.

"I'm going in now? You coming too?" He asked mischievously.

Meredith nodded as she gave him a small smile. "Just let me fill coffee in my and I'll be good to go." She said quickly. "Take all the time you need. There is no rush." Thirty minutes later both of them were entering Seattle Grace. "What are your plans for today?" Meredith asked as they walked through the lobby, both had coffee cups in their hands. "I have two aneurysms to clip, but one I think won't respond clipping I think I need to do an Endovascular Embolization or Coiling to treat this." Derek told her while Meredith just listened. "When using the Coiling method, you safely seal off the aneurysm and stop further blood from entering into the aneurysm and increasing the risk of rupture or possibly re-bleeding. Am I close?" Meredith asked as they waited for the elevator to get on it.

"You're correct." Derek pressed a quick kiss on Meredith's forehead.

"Any chance I can get in on this? I've never seen the Endovascular Embolization approach and I think it would be interesting to scrub in on that one. Of course only if you wanted me to, I mean if you don't I can wait for Dr. Bailey to give an assignment." Meredith rambled nervously.

"Mer, I'd have check with Bailey but I have no problem with having you on my service. I would be happy to teach you. You have potential in neuro and I am not saying this as your soon-to-be husband but as your teacher and attending to my subordinate. So what do we do now?" Derek asked.

"Get on the elevator and find Bailey to sign off on this. Apparently, you as an attending can per se request me." Meredith noted, her blue eyes searched and found Derek's.

Derek smirked.

"You got this perfectly right. See you later, Mer." He said as the elevator dinged and the doors opened. Meredith and Derek walked away in different ways. "With later I hope you mean your surgeries." Meredith called. "Sure." She heard his answer. Cristina had stayed the night, she was lying on the bench and was staring straight at the ceiling.

"Morning." Meredith said.

With a jerk, Cristina jolted up. "You're here." She stated. "You're here too, why?" "Burke let me scrub in on a TAD." Cristina gloated.

"That was bloody but in the end we saved the patient." Meredith looked at her friend.

While she had gotten her sleep, Cristina had logged time in the operating room. She promised herself she'd log more hours when they were through with the test.

"A traumatic aortic disruption?" She exclaimed, prying into what Cristina had been doing.

"Yep, a TAD. From the look of your face I take you're cursing yourself for missing this?" Meredith nodded. "All Derek and I had was …" "You won't tell me that you were up all night having sex?" Cristina asked in a voice that was just hilarious. "Not everything is about sex, Cristina." "So what's up then?" Cristina got serious again after her friend snapped at her. "We had a fight." She had. "Every couple fights at some point." Cristina shrugged. Meredith put her hair into a messy ponytail. "I know but since Addison we never had a fight that magnitude." Meredith told her.

"Is he avoiding? Are you not on speaking terms?" Cristina asked, halfway interested in her friend's Derek-drama.

"We're talking. Everything is back the way it was but …" Meredith sighed. "He wants me to meet my sister. I don't have a sister, Cristina beside the one I chose to be my sister and that's you." "You're going off the point, Mer." Cristina bluntly replied. "I don't want to get to know her because then I would get to hear what a perfect little life she had. We're talking about the daughter my father chose over me. Apparently, she didn't know about me before her father told her about me. And then there's the daddy issues, Dr. Webber who is acting like my father just because he screwed my mother." Meredith sighed as she sat down next to Cristina and buried her head in her hands.

"It's all too much personal crap. I am falling behind. I am logging less and less OR time. I'm two months of possible OR time due to my surgery. I can't keep this up." Cristina rubbed her hand over Meredith's back, supporting her friend.

"That surgery saved your ass." Cristina reminded her.

"The post-op infection almost killed me." Meredith only said and Cristina couldn't say anything against that. "You're avoiding, Meredith. You should stop. Derek is right." "Be on my side." Meredith told her frustrated. "Sorry, Mer, you asked for my advice and there it is: Stop avoiding. We all know you're queen of avoidance but it'll get you nowhere." Meredith rolled her eyes.

"I mean it, Meredith. Stop avoiding. We all have issues." In that moment, Izzie Stevens, Alex Karev and George O'Malley entered the locker room. Alex said a short 'Morning' but Izzie and George stayed silent.

Meredith looked up as Dr. Bailey entered the room with a determined face expression. "Rounds now." Bailey announced. Meredith stood up and followed Cristina to the first patient room. "Mara Bakers, 23, here for a tonsillectomy …" George did the presentation. The patient, a young and perky girl listened attentively. "You prep her for today, O'Malley." When they were back outside, Bailey stopped and clenched her hands onto her hips as she stared at her interns. "As you know, intern exams are in, what four days so except small procedures, you'll be learning for your exams. Believe if you don't have to repeat your intern year, you will thank me for giving you that opportunity."

Meredith raised her hand. "I've been learning for this since I got discharged. I don't need more time to prepare. Is there any chance you can assign me to someone?"

"Someone?" Dr. Bailey asked dryly. "Well, let's see how good you really are."

Izzie let out a chuckle.

She was looking forward to seeing Meredith going down. Cristina watched Stevens' reaction with a frown. She didn't like her. Something was off about her. "Stevens, since you are making fun of a fellow surgeon why don't you get a question as well? How would you like that?" "Dr. Bailey, I was just, there's no need to be …" Izzie sounded scared.

"Spare me that." Bailey snapped at her frightened intern.

Bailey really was fair, overall fair.

* * *

**_A/N: Part I got posted. I really hope you enjoyed reading this. Please let me know what I can improve and do better. Please let me know by reviewing. _**

**_So, MerDer had their first argument. But they got through it pretty well, don't you think? SPOILER for next chapters: But the Meredith and Richard relationship is pretty complex. Even lucid Ellis will make an appearance soon. Lexie and Meredith, well, they have a long road ahead of them but eventually they'll get to know each other better. But Meredith has a hard time accepting that Thatcher has chosen Lexie over her. ALSO: Upcoming MerDer wedding after the intern exam! Part II to come, probably Friday or Sunday._**


	37. Chapter 37

**Chapter 37**

* * *

**At any given moment, the brain has 14 billion neurons firing at a speed of 450 miles per hour. We don't have control over most of them. When we get a chill ... goose bumps. When we get excited ... adrenaline. The body naturally follows its impulses, which I think is part of what makes it so hard for us to control ours. Of course, sometimes we have impulses we would rather not control, that we later wish we had. The body is a slave to its impulses. But the thing that makes us human is what we can control. After the storm, after the rush, after the heat of the moment has passed, we can cool off and clean up the messes we made. We can try to let go of what was. Then again …** Meredith Grey; I Am A Tree

* * *

Lexie wasn't in a good mood. She was sitting in her old room. Nothing changed. Her parents had left everything as it was when she left. She stared at the smiley posters on the wall. She can't imagine Meredith growing up having smiley faced creatures on posters on her walls. She has been looking forward to meeting her. After she'd cooled down she wanted it. Even if she told her in the elevator that she didn't want to meet her. Maybe this was the reason for her sister rejecting her offer to get to know her. Lexie let her thoughts free room. She had nothing else to do. In this moment, Molly knocked against the door. "Get out." Lexie called as she opened the door but Molly did it anyway. "I told you this wasn't a good idea." She said tentatively. "What do you want from me, Mol?" Lexie said back. "The satisfaction that you were right and that I shouldn't have gotten my hopes up." Lexie ranted. "I just had this picture in my mind. I liked the thought having a big sister but now …" Lexie continued. Molly came in and closed the door after entering.

"She probably just needs time to warm up, Lex. This isn't the end of it. You wait a few days and then you try again, maybe you'll fail and maybe not. It's all open in the cards. You can do it, Lex. You just need to keep on faith." Molly assured her.

"You really believe this, Molly? Or are saying this to cheer me up?" Lexie answered grumbling.

* * *

"Stevens, you go first." Dr. Bailey said, her voice was intimidating to Izzie who just nodded. Meredith waited for her question which will probably be asked after Izzie got hers. "But you said that Meredith gets a question." Izzie asked in panic. She didn't want to go first. "She also said you'll get a question for attacking your co-worker." Cristina interjected in a snarky tone. "Yang." Dr. Bailey chastised her by saying her name warningly. "Sorry for that, Dr. Bailey." She apologized, not wanting to be like Izzie with her somewhat childlike behavior not only toward Meredith but all in all everyone.

"So, now that we've established that Stevens and Grey both will get a question to show off their talent, does anyone else want a question?" Dr. Bailey looked around questioningly. But everyone else stayed quiet.

"Here we go, Stevens." She introduced. Izzie shifted nervously.

"What is the procedure to repair an anterior spinal cord compression at C4 and central canal dilation?" She asked. "You're a general surgeon. I thought you'd ask me a question concerning general surgery …" Izzie stuttered a bit in over her head.

"Are you questioning my expertise in other specialties? Stevens, a well-rounded education is necessary. So yes, I know the answer to that question. If I didn't I would not be asking that question. You just earned yourself two days in the pit in a row. It's presumptuous to maintain that I haven't undergone a solid and well-rounded education including, Stevens, the basics. It's important to remember the basics. Remember this the next time you question my ability to do my job." Bailey ranted, her interns held their breaths, they feared that there was an eventual crackdown to come.

Izzie held her head down for the time being. "Grey, do you know the answer? Or any of you?" Bailey questioned her other interns after Izzie failed to answer that question. "Reduce fracture with a halo device, you follow with a C4 vertebrectomy and with a C3-5 plating." Meredith answered quickly. Cristina also attempted to answer it but Meredith beat her to it. Meredith remembered Derek telling her about this when they were learning. She was using his flashcards, the flashcards he used when he was learning for his boards. This was an advanced neuro question and Meredith was able to answer it.

Meredith had no idea why her questions were always way harder than the others but she seemed to think that it was because she had more to prove.

And apparently, she aced it.

"But Bailey, this isn't fair, she's spent way more time on neuro than any of us." Izzie complained, it appears she hasn't learned from what just happened. "Had I spent more time on neuro I would have been able to answer that question." Izzie stated, trying to save her reputation.

But everybody knew it was a lost cause.

She was acting like the enemy of Meredith without having a proper reason for it and that is what nobody understands. She is stirring up problems out of the blue.

"Did I just hear you complaining about my decision, my questions?" Bailey enquired the blonde intern.

"Uh, no." Izzie stuttered. "I just think that it isn't fair that Grey is assigned to a surgery and …" "You're not?" Bailey interjected harshly. "Is that what you wanted to say?" "It's not fair, I haven't spent as much time in neuro as she has." Izzie told her. "Boohoo, Stevens, in case you haven't noticed, life and especially work life is never fair. You might as well get used to it." She advised. "Well, she's got a boatload of reasons for being favored. For starters, she's Ellis Grey's daughter, second Shepherd and her, they are in a relationship – sue me if I start thinking of him pitching her extra surgeries. And for one, there is the whole heart thing." Izzie pointed out, her voice dripping with jealousy. Meredith was too shocked to say anything coherent. Izzie stole a heart for a patient, for god's sake. She's not getting any special treatment. There is no way she was getting surgeries due to one of her relationship with two word-class surgeons.

"Is that why you think Grey is being favored?" Miranda eyed the intern. She couldn't believe this. She personally makes sure no one is being favored and now rumor has it that Grey is being favored. Just because the girl went through something, does that mean that everyone thinks she is being favored? She needs to set these interns straight. But maybe not today, for today she'll watch them closely.

"Yes. I do." Izzie said confidently.

Meredith gasped when she heard what Izzie thought about her. When has she been favored by anyone? She has been on charts a few times after she came back. She only got the adrenalectomy 'cause she saw something pathologic on the labs. She had a reason for scrubbing in on that surgery.

"Dr. Stevens, I can assure you that none of my interns is being favored, not in any way. Also, Shepherd outranks me, as much as I don't like it, so he can make certain requests and it is my job to make sure none of you are being favored." Bailey's voice was ice-cold. Izzie scoffed. "Whatever you say, Dr. Bailey." She retorted gruffly and not in her best mood. Meredith couldn't believe this was happening. Izzie had been acting the same way when she got to know about her relationship with Derek in the first place.

She thought it was about getting ahead, him pitching her some really cool surgeries, that she was using him or he was using her … which had been complete crap.

This wasn't about getting ahead.

"Grey?" Dr. Bailey called Meredith's name. Meredith was glad she was being fair.

All the others fell silent as they held their breaths and watched the scene unfold for their very eyes. "Since you're interested in neurosurgery, I'll ask a neuro question." She said. Meredith nodded. She was ready. Cristina looked at her, she was sure Meredith would be to answer that without any difficulties.

"She gets to choose about which specialty the question will be? It's not fair to any of us." Izzie exclaimed in jealousy.

"She does not get to choose."

Bailey scowled angrily, before she once again reaches her rope with her.

Cristina groaned quietly, only for Izzie and Alex to hear. Alex Karev shot her a knowing look.

He'd been watching this. In that moment, Cristina had to suppress the urge to scream at Barbie. When anything was unfair it was the way Izzie treated her person ever since the truth came out. And Cristina wasn't the type of girl who gets angry over nothing but this was hard to watch. Meredith wasn't sure if she wanted to know what this was about. This was somewhat high school-like. Seriously, she thought to herself. "What are the differences between anoxic and hypoxic brain injury?" She asked with a straight face. Meredith knew if she wouldn't be able to answer this question it would be a satisfaction for Izzie. So she needed to be able to answer this question.

"Hypoxic brain injury is caused by a reduction in oxygen supply to the brain and Anoxic brain injury when there is a complete lack of oxygen to the brain. Both conditions can occur despite sufficient blood supply to the brain. The brain consumes 20 % of our oxygen supply so damage can happen very quickly and despite sufficient oxygenation." Meredith answered with an unwavering voice. She was completely sure of the rightness of her answer. And everybody felt it.

"What causes anoxic brain injuries?" Bailey wanted to test the young doctor.

"Do you know the answer to that?" George whispered over to Izzie who seemed to ponder what she just did. She undermined her fellow surgeon's ability to do her task with her actions and now she was being proven otherwise. That Meredith was in fact qualified of being on Derek's service. In no way she was getting extra treatment out of her heart defect. "No, I don't." Izzie mumbled back, she was obviously ashamed. "Stevens, care to fill us in?" Dr. Bailey said in booming and intimidating voice.

"Have you something to add?"

Stevens was caught off guard by the general surgeon with furrowed her brows. "Uh no, Dr. Bailey." She stuttered, she was wringing her hands nervously. "Since you don't seem interested in listening to what Meredith has to say

Alex, Izzie and George were gaping at her. Meredith really could answer all these questions.

"Grey?" She asked Meredith to continue answering the question.

"Stroke, near drowning, heart attack, drug overdose, strangulation, severe asthma event/s, accidents involving anesthesia, carbon monoxide inhalation and poisoning can be causes of those conditions." Meredith replied, she didn't see that Derek was watching the scene of Meredith answering difficult neuro questions.

"Hypoxia can also occur as a secondary injury following a traumatic brain injury, for example, when there is serious blood loss resulting in low blood pressure or as a result of brain swelling that restricts oxygen supply to areas of the brain." Meredith told her, feeling completely in her element. She loved neurosurgery. "Oxygen is crucial to the brain as it is used to metabolize glucose, which provides energy for all body cells. Most of the brain's glucose is used to send impulses and keep cells alive. Brain cells are sensitive to the effects of restricted oxygen supply and may begin to die within minutes of oxygen restriction. Therefore it's important to re-establish blood flow. The immediate outcome of severe oxygen restriction is often coma and in very severe cases brain death. Long term outcomes can be problems with cognition, emotions and movement." She summed up.

"Dr. Grey, I have to say after all the problems you put us through that I am incredibly proud of you. I have no doubt that you'll pass this test hard and with flying colors. Good job, Grey. You should think about specializing in neuro." Bailey remarked. "Well, I do." Meredith grinned happily.

"You have thought about it?" She asked.

"I have." Meredith confirmed, surprised by the turn things were taking. "You have a real talent, that's hard to come by. Don't squander it." "I just answered a few questions right, Dr. Bailey. I am not allowed to take a scalpel and operate all by myself. Only then, we'll see how much talent I have."

"Geez, you can't really accept a compliment, can you Grey?" "I just don't want people to think I got here because of my mother's legacy, simply because it's not true." Meredith knew she was talking too much. In this moment, Derek was walking forward toward Bailey and the group of interns summoned around her. He's saved her unknowingly. "Good morning, everybody, may I be able to borrow one of your interns for the day?" He said, flashing on of his McDreamy smiles. But the other interns were immune against that glance. Only it happened that Meredith wasn't. She saw that Izzie was gawking at the neurosurgeon with wide eyes.

_Mine_. Meredith couldn't help but think as she saw the way her colleague was looking at Derek.

Derek ignored the staring doctor and waited for Dr. Bailey's reply.

"Grey, you're with Shepherd. He's requested you for the day."

Meredith suppressed the urge to jump up and down. Derek had kept his word and she was on his service. "Thank you, Miranda." Derek Shepherd said. As Meredith walked up to Derek, Alex took her aside and whispered: "Wow, I wouldn't have been able to answer the question Izzie got asked and you just …"

"Thanks, Alex." Meredith smiled shyly.

Alex _was _a good guy under the harsh surface. But reality it was all just a defense mechanism. "What was that about?" Derek asked after Alex walked away. "Bailey questioned me and Izzie. I practically answered every question. I mean the first one, to be fair, was difficult. A question a fifth year neuro resident would get but I was able to answer it." Meredith told him.

"Don't make me regret it." She called back. "You won't." Derek replied. "Dr. Grey, follow me please." When Miranda was out of sight, Derek stopped and turned to Meredith who looked at him expectantly. "Did I do something wrong?" She asked awkwardly. "No, you didn't. I just heard the questions. They were pretty hard. I mean, can you tell me …" "You again with the questions?" Meredith moaned slightly. Everywhere she went, questions were following her. She would be so happy if the intern test was already over and done.

"You have a problem with that, Dr. Grey?" Derek said coolly.

Meredith flinched slightly and quickly shook her head to tell him no. "Okay, we're good to go then. What's stagnant ischemic hypoxia?" Derek looked at her expectantly. "So again about anoxic and hypoxic brain injuries?" Meredith said. Derek nodded.

"Yup. Again." Meredith thought about it for some seconds before giving him the right answer.

"It's also called hypoxic-ischemic injury and it means that there is inadequate oxygen supply to the brain due to reduction of cerebral blood flow or blood pressure and can be localized or generalized, but typically causes general, diffuse damage to the Cerebral Cortex and Cerebellum. Causes of this type of brain injury include stroke, heart attack and brain hemorrhage. Pressure on the brain caused by hydrocephalus or brain hemorrhage can also be a cause of stagnant hypoxia." Meredith rattled down everything she could think of. Hopefully it was right. It'd be embarrassing if she wasn't. But when Derek's face lights up like a Christmas tree she knew her answer has been right.

"You've earned the spot on my service, Dr. Grey. Enough with the teaching, we have a patient to see." Derek as he walked down the hall in high-speed. Meredith accelerated her pace as well to be able to catch up with him.

"The patient who is here for the aneurysm clipping?" Meredith asked.

* * *

"Yang, Montgomery needs a hand in the N.I.C.U. Go. And the others, you will spend your day in the pit and if there is not much to do you will learn for this test. This test is important, it'll determine the direction of your career. Some of you still have some serious deficits." She was looking at Izzie Stevens, hinting that she was the one who still has a lot to learn. "Dr. Bailey?" Izzie raised her hand. "You have a problem?" "Why aren't Grey and Yang here, listening to this?" She asked, Bailey felt like her intern was demanding to know that. Bailey frowned at Izzie who didn't seem to notice that and answered with: "Grey can answer the questions, Yang as well. Karev probably can too but him I didn't ask. Yang, you're on Montgomery's service, Karev, Stevens, O'Malley, ER, hustle." Izzie saw that it wouldn't work. She would have to work in the pit this day.

Her interns walked off to the ER.

"But I've got the tonsillectomy, Dr. Bailey." George warily protested. Dr. Bailey just replied with: "The tonsillectomy isn't until 12 AM so go, ER now." She ordered them. With protesting and moaning, Izzie and George followed their resident's request. Alex was already on his way down.

Yang was on her way to Addison Montgomery who said that she'll met Cristina in the N.I.C.U. Dr. Yang entered the neonatal intensive care unit after putting on a special gown for the neonatal intensive care unit. She walked through the room, past incubators with more or less premature babies or babies with severe medical conditions until she saw Addison standing over an incubator with a seemingly very young baby. "Dr. Montgomery, you requested me for today's case?" She said, coming as always straight to the point. Addison turned around as soon as she heard the young doctor speaking to her.

"I did." Addison cleared her throat.

"This little guy is Jeremiah Johnsen, gestational age is 26 weeks. He was born four days ago, has spent them in the N.I.C.U. due to difficulty adapting the changes. We have detected a *Pulsus celer et altus* meaning a large blood pressure amplitude with high systolic and low diastolic pressure." "The PDA hasn't closed yet." Cristina remarked as she heard what Addison said about the baby's pulse. "It hasn't and since he doesn't need it anymore, we need it to close. Yang, what are the factors of a not closing patent ductus arteriosus?" Cristina looked over to small baby in the incubator before attempting to answer: "A PDA normally closes within the first days of life. If that doesn't happen it can be due to low O2 partial pressure and elevated prostaglandin levels since prostaglandin is known to keep a PDA open. Therefore it's often used in babies with ductus-dependent babies to keep them stabilized before they go into surgery."

"Symptoms?" Dr. Montgomery was aware of the intern test and wanted to prepare her for it by asking her several questions about her field. "Symptoms are fatigue, sweating, rapid breathing, heavy breathing, congested breathing, disinterest in feeding, or tiring while feeding, poor weight gain." Cristina answered easily.

She loved cardiology and this was cardio. She was excellent at everything cardio-related.

"But in his case, the PDA does more harm than good and isn't closing itself. I'd treat it with ibuprofen and if that does not work, I'd opt for surgery." Cristina ended. Addison called over to a nurse so she can administer the ibuprofen. Hopefully, the PDA will close. "He'll need an echo, and an x-ray to confirm this. But sadly, this isn't his only medical problem. He's got underdeveloped lungs. Poor guy's got RDS." Addison added after a look in his chart. "Isn't Respiratory Distress Syndrome quite common in preemies this size?" Addison nodded. "Most preemies have this kind of respiratory problems. His sats are pretty low so probably it's for the best if we put him on oxygen as well. Yang, can you tell me what RDS is?" "Respiratory distress syndrome, it's also known as hyaline membrane disease, occurs almost exclusively in premature infants. The incidence and severity of RDS are related inversely to the gestational age of the newborn infant." Cristina told her in her Cristina-tone. "Treatment for RDS?" antenatal steroids to enhance pulmonary maturity, immediate use of continuous positive airway pressure and the use of gentler modes of ventilation including early use of "bubble" nasal CPAP to minimize damage to the immature lungs, it's also important to early administer surfactant, then there's fluid and electrolyte management, trophic feeding and nutrition, and the use of prophylactic fluconazole you can do to better his chances."

"Good. So what about treatment options for the PDA?" Montgomery asked.

"Well, for one there's PDA ligation and there is also the option of closing it using a catheter but since the patient's a preemie, I'd go with treating it with a dose of indomethacin since it's known to close those defects. Indomethacin is related to aspirin and ibuprofen and works by stimulating the muscles inside the PDA to constrict, thereby closing the connection. But as for diagnosing I would do an echocardiography, maybe chest x-ray and ECG." Cristina said.

"Well, let's do that. Will you please order the echocardiography?"

They did the ECHO and the chest x-ray. On the radiograph, they saw the shows poor lung expansion and an air bronchogram but no cardiomegaly due to the PDA. So that's "good". After confirming the underlying condition with those procedures, Montgomery administered the medication intravenously, hoping it would work and he wouldn't need surgery.

* * *

Dr. Derek Shepherd and Dr. Meredith Grey entered the patient room where an elderly woman waited for them. Meredith had the chart. "Good morning, Mrs. Karolinska. Dr. Grey, please present the case." Derek ordered. "Tanya Karolinska, 46, came into the ER complaining of persistent headaches and vision changes. An ordered MRI revealed a large saccular aneurysm on the basilar artery with a warning leak that needs to be fixed before it causes further damage. She's now scheduled for an angiogram and as soon as we get the results, for surgery." Meredith presented the case. "Aneurysms rupture at about 1-2% per year but it varies with the size, location and history of previous aneurysm rupture. Unfortunately, most aneurysms present because they have ruptured." Meredith said, remembering her first case with Derek, Katie Bryce with the subarachnoidal bleeding after a ruptured brain aneurysm. She presented with seizures and at first they couldn't figure out what was wrong with her. "Can you please operate before this thing in my head explodes?" The patient interjected worriedly. "Sure, we will clip the feeder to aneurysm before it causes any problems." Dr. Shepherd replied in a calming voice. Meredith started to examine the patient before she gets prepped for anything.

"These are just questions for a teaching matter. In some way our doctors have to learn too. Before they start cutting they need to be ready for it." The patient laughed, she seemed comfortable with the young doctor doing her pre-op exam.

While Meredith did the exam, the woman told them some things about herself. "Everybody needs to start at some point. I teach little children. I am an elementary school teacher. I know what you're talking about, I am very happy to teach you." She added as she looked at Dr. Grey who smiled before looking over to her boss. "I'm flattered." Meredith smiled sympathetically at the patient before continuing the exam. "Look up." Then: "Down." The patient followed her orders.

"Good." She said, she felt Derek watching her intently.

After she'd completed it, she made a quick note in the chart and put the pencil aside. Derek watched her. "Dr. Grey, symptoms of aneurysms, go." Derek surprised the young doctor but Meredith had no problems answering them. "Occasionally, large aneurysms can present with vision changes, pain above and behind the eye, nerve paralysis, localized headache, neck pain, nausea and vomiting, or other neurological symptoms." Meredith answered his questions. "How do we diagnose this kind of condition, Dr. Grey?" Derek asked his intern. Meredith cleared her throat before answering that question as well. "CT (computed tomography) and MRI (magnetic resonance imaging) are used commonly to assess patients with these complaints. These are noninvasive methods but most patients with aneurysms need cerebral angiogram for definite diagnosis and to determine course of treatment." Meredith retorted.

"What procedure is better when wanting to detect active bleeding?" Derek asked.

"MRI does not involve radiation or contrast risks, while a CT produces better resolution and is better for operative planning. Patients suspected of having a ruptured aneurysm typically undergo a CT scan of the head and a CT angiogram, which shows subarachnoid hemorrhage and the aneurysm." Meredith answered that question. "You seem to be very good." The patient noted. "She was able to answer all your questions." Derek grinned. She knew Derek was asking her all these questions because it's a teaching hospital.

"Good, prep Mrs. Karolinska for an angiogram. We'll clip this this morning after the angiogram." He said. "Go, book an OR, Mere … Dr. Grey." Derek told her.

The patient noticed his mistake and blinked as Dr. Grey left the hospital room. As she was sure that Meredith had left the room she gazed over to her surgeon. Derek was scribbling something in the patient's chart. "You love her, right?" She exclaimed with a laugh. "Is it that obvious?" Derek chuckled in reply. "It was." Mrs. Karolinska chuckled a bit, causing Derek to look away. He just couldn't hide wanting to be with Meredith. He was happy when she'll finally agree to others than his mother, Mark and Cristina about the upcoming wedding. He was looking forward to the day where Meredith would become his wife-officially. "I really can't keep a secret." He muttered to himself. The patient heard that as well. "Oh, well, dear maybe you should …" "What?" Derek smiled as he played with the pencil he was holding in his hand.

"Did you ask her out?" She pressed, wanting more information. "If you like her you should." She said, giving dating advice. Derek chuckled slightly as he revealed the truth about him and Meredith.

"Well, we are together. Meredith and I, we are involved." Derek told her. "Oh that's pretty amazing. I can tell you fit well together. How long have you been together?" "Almost for a year, at first it was more like on-off-on again but eventually we found each other and I am glad that we did and I am glad for every day I get to spent with her." Derek told her, his blue eyes sparkled with life. "Is it a secret, your relationship?" "Well, we like to keep our work life and private life apart. But our relationship is not a secret. We're just being strict professional at work. Anyway, I need to get back to work." Derek tried to find a way to get out of this interrogation.

"Marriage?" The patient asked, looking for distractions.

"We'll get married soon. We just wait for an appointment at City Hall." Derek explained. He had no idea why he was sharing all these intimate things about their relationship with his patient. "Oh, come on. It's a wedding. You think about doing it in a church."

"Meredith wants to keep it small. And I love her to death." Derek confessed. "Oh, this is so sweet and romantic." The patient beamed happily. She was trying to take her head off the surgery. "I want to build us a house on my land." He even prepared blueprints for their imaginary house in the woods. He can't wait to show her. "How romantic." Mrs. Karolinska exclaimed.

Derek continued after looking to the hallway. Meredith Grey wasn't back yet so he still had some time to discuss things with his patient. "I haven't told her yet. I will tell her when she's ready. I need to find the right moment or she flees. She scares easily."

"She loves you, right?" "She does." Derek replied with an easy and honest smile. "Then she won't run. Or maybe she will but she'll come back at some point."

"You think?" Derek felt awkwardly comfortable discussing Meredith and their relationship with this woman. She seems wise and like she's lived. "Yeah."

"So I don't have something to be scared about?"

"No. Have I?"

"No." Derek answered short out.

In this moment, Meredith entered the room again. Derek and the patient were talking but fell quiet when Meredith entered the room. "OR is booked for this morning." She said, she could barely get a word in edgewise. "Oh thank god, this ticking time bomb really scares me. I mean you said it could rupture." The patient changed the course of the conversation. "Yeah, that is one of the complications." Dr. Shepherd replied. "Complications? What are the complications of not fixing a warning leak?" The patient demanded to know. "Rupture, bleeding, death." Meredith answered.

"How soon can we fix it?" "I know you're scared but Dr. Shepherd, he is the best there is. You are in very good hands." Meredith assured the patient. "So, I still need to take some blood for the pre-op labs and then you're good to go." Meredith said as she prepped the syringe. "I'll be done in a whiff." She said. Soon, they patient was being transported to the OR that's already been prepped for that kind of procedure. "Okay, Mrs. Karolinska, I am going to inject a sedative which means you won't feel anything. You will be sleepy during the procedure." Derek told his patient. Both he and Meredith were wearing those special aprons since they are being exposed to radiation when doing this. An angiogram is an invasive procedure during which a neuro-interventional surgeon, in this case, Dr. Shepherd, guided a flexible catheter through an artery over the hip to the vessels of the brain. After they injected liquid dye or contrast agent into the vessel, they could see the structure of the blood vessels more clearly. "What do we do now?" Meredith asked her attending as she looked at the monitor where they could see the vessels. "Look, you see that form on basilar artery?" "That's the aneurysm." "It's not bleeding." Derek said. "So we're still good." The heart monitor was beeping rhythmically in the background. "Now we take pictures with the fluoroscope." He explained. Meredith nodded to signal him that she understood. This gives the highest detailed pictures of the location, size, and shape of the aneurysm which is used to determine the best treatment option." Derek added as he removed the catheter.

After completing this procedure, Meredith asked her attending if she could go grab a snack before heading to surgery. "Sure, I'll speak to the patient. I will see you in the OR, Dr. Grey." Derek smiled her lovingly as no one looked.

* * *

Meredith hinted him a smile before disappearing. Meredith saw Cristina and her other fellow surgeons sitting at a table in the cafeteria. "Hey." Meredith said as she stopped on their table. "Hi, Mer." Cristina acknowledged her presence. "I don't have much time, I am scrubbing in on an aneurysm clipping with Derek." "You're just scrubbing on an aneurysm clipping?" Cristina asked bored as she looked at Mer. "And you can't let us forget it." Izzie mumbled under her breath- Meredith raised her eyebrows as she fixated her gaze on Izzie. "What the hell is your problem with me?"

"With you? I don't have a problem." Izzie never really replied.

"I just spend the whole damn morning in the pit with treating patients with minor medical issues while you got a good neuro case just because you answered some idiotic questions every idiot could have answered." "And still, you couldn't answer them, Izzie." Meredith couldn't not say it. She had too. "So you're more of an idiot than you think." Izzie never replied. Meredith enjoyed the silence before Izzie started up again. "You always get extra time with your hubby." She said. "I just wanted a place to eat my meal in peace before going back to work. But it seems like every person I know is determined to make my life hell. I have to work doubly so hard after everyone got to know about my CHD. So what is it, Izzie?" Meredith asked her as she carefully laid her fork next to her plate as she fixated her gaze on Izzie.

"You always get the neuro cases, you are always on neuro rotation. And we others are stuck doing sutures in the pit." Izzie complained about the "unfairness" of the situation.

"So this is about me working with Shepherd?" Cristina watched the bickering between those two as she was eating her apple. As Izzie doesn't reply, Meredith groaned exasperated. This really was like high school. "Oh come on, it's a simple aneurysm repair, nothing big." Meredith downplayed it. "At least you get to see the inside of an OR. Look at us others, we're stitching up idiots in the pit. Well done; Meredith." "Oh, come on it's not all it's cracked up to be." Meredith answered, not getting down on her level. Alex and George were just sitting there, being mature and all and were eating their lunch. "Today's spaghetti on the menu, isn't it?" Meredith asked. Cristina nodded with her head in reply. "I'll be right back." She said as she walked over to the counter to get her portion spaghetti. That meal is at least eatable considering it is hospital food. Meredith returned to the table. "Have you already told people about …" Cristina asked curiously. "Cristina, not now." Meredith hissed annoyed. They weren't even alone.

"Have you already told people about what?" Izzie jumped in causing Meredith to jerk up. "Nothing." Meredith avoided. "Well, you've had your share of things you kept in the dark." Izzie grumbled as Meredith wouldn't tell her.

* * *

When Meredith has finished her spaghetti she went to find Derek. He was in his office, catching up on paperwork. She opened the door without knocking. Derek had allowed her to do that. "Derek, I'm ready." She said as she sat down on his sofa. "I have to get through this today. It needs to go out today. Will you wait for me till I'm finished?" He asked without looking up from his desk. "Sure." Meredith replied, she snatched one of his neurosurgery journals and skimmed through it. "Yeah, of I will. I am hiding." "Hiding?" Derek replied with a frown. "Why are you hiding?" He put his pencil aside as he looked at Meredith for a moment. He saw that she has problems with one of her colleagues that is supposed to be her friend but doesn't act like it. "I'm hiding because Izzie is out to make my life hell." "Jealousy. She knows you and Yang are the interns to beat and has no way to change that." Derek told her. "Are you okay?"

"I'm fine. Why wouldn't I be?" Meredith replied. Derek sighed. Meredith was shutting him out. He just hoped she'd come to him later on when she can't do it anymore.

Later, as his patient got prepped for the surgery, he walked into the operating room. "See you afterwards." Derek told his patient as he put on his lucky scrub cap. Meredith was still in the scrub room scrubbing in. When Meredith entered the operating room the patient was already under and they were ready to start. Meredith noticed that Derek was wearing his ferryboat scrub cap. He said the exact lines he always says before cutting someone open.

"It's a beautiful day to save lives. Let's have some fun."

They were doing a keyhole craniotomy. They were clipping the aneurysm. He started by making an incision in the skin over the head, Meredith was watching closely. The neurosurgeon continued to make an opening in the bone with the needed instruments and dissect through the spaces of the brain, he mobilized the posterior communicating arteries. Meredith stood next to him with the suction and irrigating the spot so that he has clean visual field. "I am placing the temporary clip on the basilar trunk." He said as Meredith watched his precise moves. She could only dream on this herself, maybe she'd do something like that in her third year. She could only watch, take in the thrill of the cut.

"Can you believe this?" Sometime into the surgery, Izzie's persistent voice said. Meredith heard it over the intercom. They forgot that when the red light blinks, it's on speakerphone. So Meredith was able to listen to their conversation. "Just because she can answer every damn question in the book it doesn't mean she's superwoman." Izzie made a snide remark, stirring up trouble. Alex tried to ignore the sneering remarks of the blonde intern. Only Alex, Izzie and George were there. Cristina was down in the pit, working on patients or in the N.I.C.U., working on the preemie case. She was working as in really working. "I mean, I accepted that has this fling going on with Derek and all but does that mean she gets all the good cases? I don't care what she does with him. That's her problem but it is my problem when it interferes with my surgical career and education. She's constantly stealing my surgeries as she did with the adrenalectomy." Izzie complained non-stop. Meredith swallowed and turned her view to the side, focusing back on the surgical field. Derek glanced up as well. He'd heard them talking. When he heard Izzie saying that his relationship with Meredith was just a fling his blood started to boil.

She's not a fling. How dare she say that? How dare she?

Derek closed his eyes for a second, only to open them a second later and continue with the surgery. He felt Meredith's presence next to him and tried to block everything else out.

When Meredith looked up to the gallery, she saw her peers sitting there and watching her. "She's the only one who got a surgery today. Those daddy issues are working for her. And she's got her neurosurgeon boyfriend who lets her scrub in on all the good cases." She said with enviousness. Meredith felt her chest tighten in anguish. She couldn't believe how some of her so called friends slowly turned against her. It was like a stab into her body as she realized that. Meredith slowly looked up to them, keeping a straight face and not letting them know how much these words hurt her. She tried to cover it up.

Alex groaned repressed, rubbing his hand over his face.

"I got a surgery too, she's not the only …" He was cut off by Izzie: "Just because Robbins needed a hand, Alex. Otherwise you'd be stuck in the pit as well." "Well you don't look like you're stuck in the pit, Stevens. Just stop trying to crush Mer!" He exclaimed. "Why are you taking her side? She hid this from all of us." "What this?" Alex snorted at Izzie's ignorance. He's grown fond of Meredith and just couldn't explain Izzie's unexplainable behavior. "Well, when looking at your extraordinarily immature behavior it might have been the correct choice. So yeah, I'm choosing hers. She's like a sister to me and brothers protect their sisters when they need it." "Sister? You're not her sister, she's an only child, asshole." Izzie just scoffed. "We might not be blood-related but she is and don't dare question that. You have absolutely no right to do this." "Zzz, just because everyone's become worried about her and all, she …" Alex got up from his seat in the observation room and faced the blonde doctor. Izzie continued to sink in his esteem.

"You do this to her just because she's suffering from a CHD? Are you freaking hare-brained?"

Before Alex could go on ranting, his pager shrieked. "It's Robbins, I have to go." "Dr. Karev, would you mind turning off the intercom so we could get a little piece and quiet down here?" He asked.

"Sure, Dr. Shepherd." He said as he got up and turned off the intercom, glancing for one last moment down and then left. He walked toward the pit where Robbins was waiting for him. "Alex, there you are. We've got a ten year old with a possible tibia fracture in more than one place." She told him. "Ambulance is four minutes out?" "Should I call orthopedics for a consult?" Alex asked, now fully in work mode. Arizona nodded. "Also secure an operating room just in case." She said as Alex nodded in understanding. He ran off to the nurses' station and paged orthopedic surgeon Dr. Callie Torres who came within the next two minutes.

Izzie has fallen silent after Alex left and Meredith was thankful for that. Meredith's breathing has been accelerated a bit after hearing what Izzie thought about her. Derek felt her sucking in air, trying desperately to concentrate on what's important. She can't give Izzie this kind of satisfaction. As Meredith felt Derek's concerned glance lingering on her, she gave him an imperceptible nod telling him she would be okay and that she wasn't on her way of hyperventilating. Slowly her breathing eased up and slowed down. "Let's continue." Derek noted as he saw that Meredith would be okay. "This prevents the blood flow from entering the aneurysm." Meredith said as he placed the clip across the aneurysm where it arises from the blood vessel. "Correct." The scrub nurse handed him the Penfield 4, the neurosurgeon carefully navigated through the mess of perforators so that he wouldn't nick them and followed the PCA back to the basilar tip. Soon he had located the neck of the aneurysm. "Continuous suction, Dr. Grey and I am going to need a straight seven millimeter clip, Bokey." Derek ordered as he concentrated on clipping the aneurysm. "It's berry-shaped." Meredith suddenly noted."It is." Derek confirmed.

He then applied the clip and both he and Meredith held their breaths. But nothing happened. "Clip is on, there's no bleeding. How are the patient's sats?" Derek asked, looking up from the microscope.

"BP's holding steady, 112 systolic and heart rate's 77." The anesthesiologist noted.

"ICP's in the normal range." Meredith looked at the monitor. "Good. Get ready for matador move." Derek announced. The scrub nurse handed him the needle to make sure he'd completely ensured the aneurysm. He inserted the aneurysm dome and only a little blood trickled out of it, meaning he had done his job right. He released the temporary clip to re-establish normal blood flow to the brain.

"Meredith, you want to close up?" Derek asked her.

"Sure." Meredith replied as she glanced at her superior. "You can do it." He encouraged her. "I know. And I like you breathing down my neck like this. Sorry this was inappropriate." Meredith said, he was hovering as she did what has to be done. Meredith put the piece of the skull back where it belongs. When they finished the surgery, the patient was moved to PACU to be monitored. "I'll stay the night." Meredith said. "I want to have to pull an all-nighter." She said. "Maybe then someone will respect me."She said defeatedly. Derek noticed that something was wrong by solely looking at her and listening to her words.

"Don't work yourself into the ground." Derek, as always, was concerned about her.

He knows she'll work until she can't anymore if no one stops her. She is that stubborn. "Derek … Dr. Shepherd, I assure you there's absolutely no need for being concerned. I can pull this off, an all-nighter. Everybody does, I am an intern, I need to log more hours in the OR and that is the right way to it." Meredith told him as she walked toward the post anesthesia care unit where her patient was being monitored until the anesthesia's wearing off. "Just remember to make sure that you make breaks whenever possible and eat and drink on a regular basis. We don't need to add dehydration to the list."

"Well, that sounds somewhat familiar." Meredith noted.

"Derek you don't need to hover all the time. I'm okay, I really am. Stevens' words don't hurt me." Derek knew she meant the opposite but he didn't let on that he got the real message behind her sayings.

"Okay then, Grey, you page me she makes up. Do a neuro exam every three hours." Derek said. Meredith was familiar with post-surgery protocols but he said it anyway. "Derek." Meredith called after his retreating back. "I will monitor her but is it possible that I could find Cristina for a minute? Then I can go back to my doctor duties." Meredith really hoped he would agree. But maybe he'll play the attending card and won't let her. Derek nodded, taking in Meredith's expression. He could read defeat and silent anger in it.

He figured it was due to the cold and harsh treatment she was getting from Izzie albeit with no good reason for it.

"Ten minutes coffee break." He told her but suddenly his features changed noticeably. He was more like the Derek she knew outside the hospital and less the attending Dr. Shepherd. "But …" He began and after glancing to the right and left, he pulled her with him into an on-call room and closed the door behind him. Meredith looked at him, not knowing what he wanted.

"Is that how the others treat you?" He said in a serious tone.

Meredith pressed her lips together before nodding resignedly. "They hate me. At least Izzie does."

"She lives in your house, Meredith." Derek noted. "I know." Meredith took a deep breath. "But I don't get it. Why is she so determined to make my life hell?" Meredith asked helplessly. "She just humiliated me and us in front of an entire OR team." Meredith shook her head, she didn't understand why she was suddenly Izzie's enemy. "She'd been complaining about me being your service. She thinks I'm … that you favor me." Meredith told him. "I know, right now you're not my fiancé, you're attending. I can't keep doing this." Meredith said. "You can't keep doing what?" "I'm good at what I do." Derek nodded in affirmation. "But she makes me feel like I am not deserving this. That I am not able to do this, the last she acted like she does now was when she found out." "Found out about what?" Meredith let go of whatever held her back and spilled what was on her mind. She paced up and down in the small room. "Our relationship, you remember, we've been hiding it at first. I am talking about the time before your wife …" "Ex-wife." Derek cut her off. "Before your ex-wife came into the picture. She asked me why I was doing this. I had the respect without doing anything. She thought I always had easy which I hadn't. She was asking why I was letting the respect taken away just, if this was about getting ahead and for some surgeries … she didn't realize that I was falling for you." Meredith told him, she was avoiding looking at him.

Derek sat down on one of the bunk beds. He motioned Meredith to sit down as well. Meredith listened to him without questioning him. She stared straight ahead. He could tell that this was hitting close to home for whatever reason.

"I had their respect, Derek, without having to do anything and now I have work my ass off, not that I am complaining. But she's got no respect for me, no respect at all."

"Izzie?" Derek asked, frowning.

Who else should I be talking about?" Meredith said back, strained. "I can answer as many questions as they ask me to but she still treats me like crap. And the worst is, Derek, I think she does it because of my medical history. I mean, why else should she do it?" She asked. "Meredith, stop pacing." He stopped her by putting both hands on her shoulders. "I don't know." Derek honestly replied. "I've never given her a reason to do all this. Why is me being born with a CHD such a problem for her?" "Conflict of interests maybe?" Derek pointed out. "She thinks you get the easy way out or she wants to attract attention." He thought loudly. "You think? I mean, when she wants to attract attention, the right way to do that is learning for the intern test and pass it hard. That's how you earn respect and so on."

"Are you scared of it?" Derek asked silently. "The test? No, I don't." Meredith answered, as she looked over to him for a slight moment. They paused for a moment. Meredith said for another time, emphasizing what she didn't get: "I just don't get it how she can do this. How can she treat like this when she lives in my house?" "I can't have her doing that. She can't continue treating you like this." "How bad is it?" Derek asked concernedly. "Do you need to hug it out?" He asked. "Yes, please." Meredith's voice quivered a little bit. Derek pulled her small frame into a loving hug. "'s better." Meredith murmured softly. After some time, she slowly released the grip with what she held onto Derek's body. She gazed up to him as she asked: "How do you think this will be when we're married, actually married?"

"I don't know. Let's just see what will be." Derek said. "You can't do anything anyways so why spending time wracking your mind about something that you cannot necessarily influence."

"This is exactly why I didn't want to say anything." Meredith suddenly said.

She couldn't help but feel anger toward the all-in-all situation. "But I didn't think it would as bad as it is now. I'm lucky to have friends like Cristina and Alex and my very supporting husband." "We're …" Derek noted but he didn't end it. He liked it that she referred to him as husband. He liked that even if they weren't – for now.

"I think we need to go, do our doctor stuff." Meredith mumbled.

"Doctor stuff, Meredith, really?" Derek asked, he couldn't help but grin at the absurdity of the choice of words. "What? It doesn't matter if it isn't a real word. You understand me anyway. And if you're being honest you love me for it." She smiled at him. Time with Derek was making up for the time she spent with judge-y Izzie Stevens. "I do. But as you pointed out before, we've both got some stuff to do with our time, Dr. Grey." Derek said, his voice switching back into attending mode. Meredith rolled her eyes for a moment, luckily Derek didn't see it as she was following him out of the room.

To their luck, Izzie Stevens passed by.

"How sweet, attending and intern hanging out in one on-call room. Sure that that wasn't post-surgery sex?" She bluntly remarked as other nurses and orderlies passed by as well. They stopped and gawked of course. Derek felt his blood boil with anger. "Dr. Stevens, this is no way to speak to your attending. I forbid that kind of behavior. I demand to be treated with respect as does any other doctor around here." "Is 'any other doctor' by any means Meredith?" Izzie asked innocently.

"Dr. Grey, would you please excuse us and tend to your patient in post anesthesia care unit and see if she's ready to be moved?" This was him treating her as any other attending. And that was okay.

She didn't want to be favored.

Not by him, not by anyone. It wasn't fair to anyone if she got the easy way out. But she didn't so that was good. Meanwhile, Izzie Stevens was facing a very angry Dr. Shepherd who looked at her in annoyance and anger. "Stevens, I am your attending. You're not authorized to speak with me like that. There is a pile of charts at the nurses' station that's needs to be done. I would have let Meredith go through that in all fairness but due to your undermining comments, I'm afraid your mind is occupied with other things. So, you're gonna be charting." Derek told Stevens off. "I want complete charts with ECG. If they haven't done one yet, it's you who's going to do it. Patient in 3472 needs a new IV access and he's a hard stick, dressing changes in post-ops 2367, 2456, 2136 and 1244. Got it?" Izzie was enraged, how could he punish her with putting her on scut? He should put his girlfriend on scut. That would be more fair. "Yes. I've got it. Derek." Izzie called him by his first name. "It's Dr. Shepherd to you, not Derek. It's not Derek, not here at work and not in the house. My name's Dr. Shepherd and you will call me that way." Derek managed to keep his voice down but this girl was sheer hell. "Sure, I will do that. Dr. Shepherd." Izzie emphasized his name unnaturally before walking down to the nurses' station.

* * *

After her surgery she told Derek, she would look what Cristina's doing. She is probably in the NICU. Addison had her on the preemie case. "Cristina." Meredith said as she walked next to her. "You just got out of surgery. I saw part of it. Shepherd let you close up." "He did." A huge smile graced Meredith's face. "How is your case?" "Barely holding on, it doesn't look good. Montgomery is looking into other options." Cristina told her as they walked up to NICU. "What about you?" "I am supposed to monitor my post-op patient but I have a ten minute coffee break right now." Meredith told her. "Ah, good." Both interns put on NICU gowns and were greeted by Arizona Robbins who had pulled out a stethoscope and listened to one baby's lungs. "Wait, we'll try liquid ventilation on her." Addison said, a determined expression was covering her features. Cristina listened in utter surprise. Liquid ventilation? Cristina stared at her attending who was about to do something brand new and experimental, very experimental in fact. But everything else they've tried to do before failed miserably. This was like their last chance of really doing something to help this baby getting better.

"That's highly experimental." She stated as she watched Montgomery taking the preemie's vitals and checking the breath sounds. "Yes." Addison answered shortly. "Have you ever done it before?" Cristina asked ambitiously, even though neonatology wasn't what she wanted to do for the rest of her life. She wanted to try this to give this newborn baby a chance. "No, but I am about to do it now, to give this patient a shot at living. The fluid will expand her lungs so that they don't collapse." Addison said as Cristina watched her perform this bedside. Meredith suddenly entered the NICU, Addison never looked up since she was focused on her patient, only Cristina turned around and acknowledged her friend's presence without much words. "Need a hand?" She asked as she saw what they're doing. "You're trying liquid ventilation?" She exclaimed. "Grey, be quiet please. I need to concentrate." The redhead scolded the eager intern.

Meredith nodded. She knew that that was better for the baby.

"We're simulating the womb. Keep an eye on her sats. If they go up it is working." Addison said to Cristina. "I'm going to watch this, this is a genius move." Meredith said as she stepped nearer to the incubator with a very little sick preemie with underdeveloped lungs and breathing difficulties to watch this bedside procedure. "This sucks." Meredith silently said. Cristina nodded. "Montgomery, sats are falling." Meredith warned, energy surging through her. "Give me a second." Addison retorted eerily calm. "Come on, come on." She was trying not to panic while fluid was expanding the baby's lungs. They controlled it via roentgenogram. The fluid filled the baby's lungs.

"There we go." Meredith said, a smile covering her lips as the saturation went up and the color significantly changed from cyanotic to normal baby color. "We got it." After the repeat chest radiograph after surfactant therapy demonstrates marked improvement.

Shortly after, Meredith was back on her way to post anesthesia care unit. Happily she noticed that her patient was very much awake at this point and ready to move to stepdown unit. "Welcome back, Mrs. Karolinska. I am just checking if everything is in working order before I can give the order to move you to stepdown unit." Meredith told her in a calming voice as she did a quick neuro check. "Can you move your arms for me?" Meredith asked. The patient followed her commands without any trouble. "Excellent. How about moving your feet?" After the patient did that as well without any problems Meredith moved on to next part of her exam. She was shining a light into the patient's eyes to see how the patient responds. "Follow the light, please?" "Good." and was taking her vitals and after asking the patient to pull up her shirt she pulled out a stethoscope to listen to her lungs and heart. After documenting everything she called for a nurse to get the transfer done. After the paperwork was done, Meredith's patient was moved. In that moment, Meredith's pager beeped loudly.

It Burke paging her and Cristina to the pit. Cardio trauma, sounds like this could be a long but interesting night.

"A trauma." Meredith said as she scanned her pager. Meredith turned and walked toward the emergency room, suddenly she had footsteps following her.

"You have been paged too?" Cristina asked as they jogged down the hallway and to the pit. "Must be something big." She added knowingly. Burke was awaiting them impatiently. "There you are." He lead them to a trauma room. "What do we have?" Cristina prodded. "Triple-A? Traumatic Aortic Disruption? Injury to heart or / and lungs? Tear in the ventricle? Does the patient have to go on bypass to repair the underlying damage?" Burke didn't say anything, instead he gazed over to Meredith. He'd heard from Cristina how Izzie treated her. "Dr. Grey?" Dr. Burke said her name.

"What's a cardiac tamponade and how do you treat it?" After Meredith answered that question correctly, they entered the trauma room. The patient had suffered significant trauma to the chest.

His chest rose and fell in an accelerated pace, Meredith noted as they started with the primary exam.

* * *

_**A/N: Sorry for not being able to post this earlier but I had things planned for the weekend. But now I am ready to post, obviously. I hope y'all like this chapter and review. **_


	38. Chapter 38

**Chapter 38**

* * *

** We like to think that we are rational beings; humane, conscientious, civilized, thoughtful. But when things fall apart, even just a little, it becomes clear we are not better than animals. We have opposable thumbs, we think, we walk erect, we speak, we dream, but deep down we are still routing around in the primordial ooze; biting, clawing, scratching out an existence in the cold, dark world like the rest of the tree-toads and sloths. There's a little animal in all of us and maybe that's something to celebrate. Our animal instinct is what makes us seek comfort, warmth, a pack to run with. We may feel caged, we may feel trapped, but still as humans we can find ways to feel free. We are each other's keepers, we are the guardians of our own humanity and even though there's a beast inside all of us, what sets us apart from the animals is that we can think, feel, dream and love. And against all odds, against all instinct, we evolve.** Where The Wild Things Are; Meredith Grey

* * *

In that moment, Meredith's pager beeped loudly. Mrs. Karolinska looked at her in apprehension. "If you need to take this, go. I'll be fine on my own." She assured her as Meredith glanced onto her pager. _911 ER. _It was Burke's pager number, Meredith realized as she looked over the screen of her pager. She put her stethoscope away and said shortly toward the patient: "I'm sorry, I need to take this. It's an emergency." Meredith said her before sprinting out of the room and toward the emergency department. It Burke paging her and Cristina to the pit. Cardio trauma, sounds like this could be a long but interesting night. "A trauma." Meredith said as she scanned her pager. Meredith turned and walked toward the emergency room, suddenly she had footsteps following her. "You have been paged too?" Cristina asked as they jogged down the hallway and to the pit. "It must be something big." She added knowingly. "Yeah, probably, do you know whether the others are on call as well?" Meredith asked a pretty normal question. "Why? Are you scared to face Izzie after what she thinks about you?" Cristina said sarcastically without really thinking. Meredith hadn't reckoned with that kind of question she was taken by surprise.

"I don't care what she thinks of me." Meredith replied, her voice quavered slightly and Cristina could read her like a book.

Meredith didn't scare easily and currently, Meredith Grey was panicking by the mention of Izzie Stevens who was out to make her life hell. "She'd probably freak out at the mere prospect of me getting paged to this trauma instead of her. But you know I'm fine. I am perfectly fine. Also, Derek is having her doing his patient charts because she was disrespectful toward him." She rambled, had a hard time stopping if no one stops her. She mumbled under her breath.

"However, we have more important things to worry about such as this patient."

Meredith was flummoxed by Cristina's comment.

She was aware that she hasn't meant to be insensible but she couldn't say that it hasn't affected her. But she and Izzie weren't exactly on good terms. For some reason, Izzie couldn't stand with her. "Yeah, let's just worry about that." Cristina quickly backpedaled as she sensed that her comment has let Meredith backfire. Then Cristina and Meredith entered the emergency department. They walked in on Burke attending to patient as two paramedics pushed the gurney to the nearest trauma room. From the sound of the heart monitor it was clear that the patient was on the verge of collapsing. He was bradycardic and hypotensive, probably in shock. His airway was maintained and a tube was breathing for him. "Grey, Yang, I need some hands." Dr. Preston Burke called out. Meredith saw that they were already letting fluids running wide open to keep up with the extensive blood loss.

Burke was awaiting them impatiently. There was a trauma they needed to attend. This was not going to be a quiet night. It was more like going to be hectic. "There you are." He led them to a trauma room. "What do we have?" Cristina prodded. She was looking forward to spending the night in the operating room as did Meredith. "Triple-A? Is this involving Traumatic Aortic Disruption? Injury to heart or / and lungs? Pulmonary contusion or contusion of the heart, did the patient arrest on the way to the hospital? Tear in the ventricle? Does the patient have to go on bypass to repair the underlying damage?" She spilled possible injuries of a patient with chest trauma. Burke didn't say anything to Cristina outburst of possible diagnoses. Instead he gazed over to Meredith. He'd heard from Cristina how Izzie treated her as if she was unable to do her job but hell, she was wrong when she thought so. He was with Bailey and Shepherd on this one. Maybe they needed to have a serious talk with Stevens who only seemed to have a problem when it comes to Meredith. The paramedic walked over to them and gave them a quick overview of the status of the patient. He told them he'd coded once when they were on their way but they have been able to resuscitate him very quickly. They entered the trauma room. "Patient is 23 year old male, was in a high-speed MVA, he has sustained thoracic aortic injuries and injuries to the heart and lungs." He told them the details of this case.

"I need a hand, or more both of you. Dr. Grey?" Dr. Burke said her name harshly as he was her superior. Meredith didn't seem surprised that she was being asked.

Ever since her surgery she has to work doubly so hard to prove that she can do this than before. "What's a cardiac tamponade and how do you treat it?" He questioned her. Cristina raised her arm. Pick me. Pick me. Pick me. Burke's eyebrows furrowed amused. But he said: "It's Grey's turn, Dr. Yang. You'll get your chance to show off your talent as well." He noted. Cristina smiled and then turned to Meredith, waiting for her to answer. "Pericardial Tamponade is accumulation of blood in the pericardial sac of sufficient volume and pressure to impair cardiac filling, resulting in reduced ventricular filling and subsequent hemodynamic compromise. It's a medical emergency. Leaving it untreated, it would result in death. Patients typically show signs of hypotension, muffled heart tones, Pulsus paradoxus, and distended neck veins. Diagnosis is made clinically and often with bedside echocardiography. The Treatment for this kind of condition is immediate pericardiocentesis or pericardiotomy." Meredith answered quickly as her eyes darted to the patient's heart monitor.

He was hypotensive and he had bruises on his chest. There was evidence of chest wall injury. He was intubated and ventilated using the PEEP mode that was more protective to the lungs. Meredith answered that question correctly, as Burke said: "Order a CBC and an arterial blood gas, Dr. Grey. We need to place a chest tube to avoid complications such as ..."

"… tension pneumothorax, hemothorax." Cristina was quick to answer.

"You're placing the chest tube, use one with a large lumen." He advised her. Cristina quickly put on sterile gloves before reaching for the chest tube that was lying on the tray among other instruments.

"Hemopericardium with a cardiac tamponade, he's showing signs of Beck triad and other symptoms related to an acute tamponade which means he's most likely tamponading, get me a crash ECHO to confirm this." Burke spurted out during the initial evaluation. The ECG was additionally showing a "low-voltage" rhythm. A nurse got a portable ultrasound and Burke reached for the transducer. The chambers were getting progressively smaller and diastolic compliance is reduced, he immediately noticed that, the patient's skin was getting cold and clammy due to hypotension.

He was preparing to do an emergency subxiphoid percutaneous drainage or also known as pericardiocentesis which is done in unstable patients when cardiac tamponade is suspected. He knew that that kind of procedure has a mortality rate of approximately 4% and a complication rate of 17%. Meredith was holding the transducer to monitor everything during the insertion, making sure that there is no ST segment elevation that's indicating contact with the epicardium and the need to withdraw the needle. He was coming with the needle, carefully so that he wouldn't puncture the heart. This is a life-saving bedside procedure. The subxiphoidal approach is extra-pleural; hence, it is the safest for blind pericardiocentesis. Dr. Burke inserted a 16- or 18-gauge needle at an angle of 30-45° to the skin, near the left xiphocostal angle, and was aiming towards the left shoulder to drain the excess fluid around the heart. Cristina and Meredith were both looking at the monitor, holding their breaths as the rhythm slowly stabilizes.

When they got the patient stabilized, they were going to do the chest radiographs and also plain films of head, abdomen, neck and pelvis to make sure there are no other injuries they might have missed. But all films came back clear which was a huge relief. "So there's no need for other consults as the films came back clear." Burke noted as he moved on.

"Grey, I'm gonna need your help with the chest radiographs. We need to make sure that the patient has no aortic injuries, or we're looking at rapid deterioration. If that happens …" Meredith looked up as she pushed the portable x-ray toward the gurney and placed it correctly so they could take pictures of the man. "… They are dead man walking." Cristina said bluntly. "The patient's sedated but we don't know how much they feel and hear of all of this. This is a patient, Cristina. Do not talk like that over the patient." Burke scolded her. Meredith was occupied with taking the radiographs of the patient's chest. When they did that, they saw the extent of the injuries. The mediastinum was wide and kind of funny-looking, there also was deviation of the trachea the right and there was depression of the left main bronchus. There was no clearly visualized aortic outline. While many signs of aortic injury have been reported, the most sensitive indicator of blunt aortic injury remains an 'abnormal mediastinum'. Meredith also noted that there was a lot of bright blood in the chest tube. "Dr. Burke, look, there is extensive blood loss via chest tube." She said as she held up the chamber that was filling with blood. "Let's save that patient. Time is …" "… everything." Both of them replied in a chorus. The patient had suffered significant trauma to the chest. His chest rose and fell in an accelerated pace, Meredith noted after they finished the primary exam. After they got him stable for transport, they were taking him down for a CT to confirm damage to the aorta and surrounding tissue.

His lungs were also bruised, he had fractured a few ribs, meaning, he'd be in for a painful, excruciating recovery. If a normal recovery after a sternotomy was painful, she can't imagine how it is to have to recuperate from an injury like this. This has to be particularly painful. "Prepare for moving." Cristina and Meredith helped Burke getting the patient down to CT. "We need to be quick." She said to Meredith. "Most patients with aortic transection are dead on arrival. We're incredibly lucky that this isn't a transection."

"I know." Meredith answered as they got their patient to CT.

When their patient was in the machine, Dr. Burke, Dr. Grey and Dr. Yang were impatiently waiting for the results to come up.

"C'mon, hurry up computer." Cristina mumbled impatiently as she whipped with her feet. Burke and Meredith were watching her as suddenly the images plopped up on the screen. "We have images." Burke suddenly announced.

* * *

"Okay, what do we have?" He asked as he gazed at the image very closely as did Meredith and Cristina who were as concentrated as he was. "I see a pseudoaneurysm on the aortic arch." Cristina pointed with her finger at the plain film. "There is damage to the ascending aorta, there is also a mediastinal and in addition a periaortic hematoma which is much more suggesting an aortic injury than an aortic injury alone, and the motion artifact." Burke somberly ran his fingers over the defect. Meredith was looking at the image closely before feeling the need of noting something. "Most blunt aortic injuries are at the proximal descending aorta and are visible on axial CT as a pseudoaneurysm bulging anteriorly or antero-medially at the level of the left pulmonary artery." "I have to say, Grey, you are right with that." Burke said, he had the right interns for this case. "But what we also need to do, is getting him out of that machine and to an OR. Time's a wastin', guys." Meredith pressed the button to get the patient out of the machine. They were definitely opting for an open surgical repair. After they did a CTA chest, they moved the patient to the OR to get this taken care off. "I need the hands meaning you're both scrubbing in with me on this one." Meredith and Cristina looked at each other. They knew what the other one thought about the possible prospect of scrubbing in on this kind of surgery. A distinct smile was forming on both of their faces. Burke's mouth twitched amusedly. Then he cleared his throat but neither of them seemed to hear him. The patient was being prepped for emergent surgery, so he used the time for teaching since intern exam was coming up and they needed to be prepared for that.

"Yang, options for TAI repair?" Burke directed his question to Cristina who seemed to be taken by surprise, at least in the first second. But she recovered very quickly from her shock and was able to answer her superior's question: "Treatment options for TAI can be divided into three categories which are open surgical repair, endovascular repair and medical management." Burke nodded. As the patient was being prepped for surgery, he used this time for asking complex questions about pleural effusions and other complications. "What are the common causes of cardiac tamponade?" Burke asked as Cristina put on a surgical mask. "Malignant diseases are a common cause of this, also pericarditis, post-pericardiotomy syndrome …" Cristina listed. "It also occurs in Type A aortic rupture."

"… which might be the reason our patient suffered from cardiac tamponade." Burke noted.

Cristina nodded eagerly. "What can you tell me about the different procedures of relieving a cardiac tamponade." Burke started.

Cristina grinned as she told him the answer. "Removal of pericardial fluid is the definitive therapy for tamponade and it can be done using the following three methods to relieve the pressure that's building up around the heart: emergency subxiphoid percutaneous drainage, echocardiographically guided pericardiocentesis and then there's percutaneous balloon pericardiotomy that's very similar to echocardiographically guided pericardiocentesis. As for surgical Care in hemodynamically unstable Patients can a surgical creation of a pericardial window be useful." Cristina answered his questions.

"Where is Grey?" Burke suddenly asked. "Maybe you should let one of the nurses page her." Cristina offered.

* * *

Meredith on the other hand got caught up in talking. "Meredith, wait." Derek jogged so he could keep up with her pace. "I can't, I'm supposed to be in the OR by now. I have a patient who's critical and hemodynamically unstable." "You were too." He said silently, thought Meredith didn't hear him. But she can't remember a point where she was hemodynamically unstable. Was this before or after her surgery? She asked herself that but she didn't say anything. It could wait. Her patient can't wait. If he would have to wait he'd be dead in what, a few hours? Meredith walked toward the ORs but stopped at the OR rotation. Due to the sudden stop, Derek bumped into her accidently as he wasn't able to stop before. "Meredith." He got out. "Why did you stop in the middle of walking?" He asked, as he ran his hands through his hair in a stressed mode. "Derek, I am about to scrub in on a sternotomy to repair a heart and an aorta that is almost ruptured. Cristina and I are scrubbing in so I am gonna be awhile." Meredith gushed enthusiastically, she loved doing this.

Derek smiled warmly. He loved seeing Meredith lighting up at a possible surgery.

"Well, Mer, you're incredibly lucky. All I am looking forward to is paper work, some bureaucratic traffic, something that needs to be signed right away." Derek sighed, Meredith is in the OR while he has to catch up on paperwork. "I am going to get coffee. You want too?" He asked her as they made their way toward the vending machine.

"I can't, I have a surgery in ten minutes." Meredith declined the offer of the neurosurgeon. "C'mon, one coffee won't hurt." Derek tried again.

Meredith had to laugh at his attempts to get her to go on a coffee date with him but Meredith didn't change her mind. At some point of all of this, her pager interrupted her conversation with her favourite attending. "See, that's what I am talking about, Dr. Shepherd." Meredith held up her pager. "OR 5 is ready 'n prepped. I need go, crash sternotomy."

She kissed him quickly on the cheek before disappearing down the hallway. Cristina was already there in the scrub room, her gaze was lingering on her as soon as she entered the room. "You're late." Cristina noted in a snarky tone. "I am not." Meredith replied while rolling her eyes. Burke isn't even here and I answered my page as soon as I received it." Meredith defended herself, knowing Cristina was an empty threat and not meaning any of this. And she was right. Only seconds, after she thought that, Cristina continued talking to her as if nothing happened.

"I was just kidding." Cristina grinned as she washed herself sterile. "Gotcha." She added with a smirk. "Fine, can we please move on?" She asked, hoping she'd let it go. "Sure." In this moment Burke entered the scrub room. "Patient ready?" He asked monosyllabic. "He's ready and prepped to go." Cristina was quick to answer. "Good, ready to save a life?" He asked both of them. "Yeah, we are definitely ready to save this man's life." "Then let's go." Burke announced as he entered the operating room. Meredith and Cristina followed him. They were greeting by the monotone beeping of a bunch of medical machines all to monitor the patient's vitals. The surgery was taking hours, the patient received at least four units of blood since he was losing very much due to traumatic aortic injury which is rare but frequently fatal, it's a condition that needs prompt diagnosis and immediate treatment.

"Scalpel." Dr. Burke was about to do a median sternotomy to gain access to the chest cavity. He needed clear visibility of the heart and the great arteries. When they had opened the patient up, they had clear view of the heart, the aortic root and the ascending aorta as well as the aortic arch where the injury was located.

"Prepare to do an interposition graft as soon as we get this bleeding controlled."

Suddenly, the heart monitor went off crazy. The patient was officially unstable. They were seeing the blood spilling from the injury. "He's losing too much blood to fast Sometime into the surgery, Dr. Burke was doing an interposition graft that is slightly higher in attenuation than the native aorta and will have a slight contour change at both the proximal and distal anastomoses. Meredith and Cristina watched him doing this. They were holding the clamps in place or suction when needed. All in all it was a good surgery. Suddenly Burke looked up. "When do surgeons decide to perform open repairs?" He asked both of his interns. "An open repair is still the procedure of choice to repair injuries involving the aortic root, ascending aorta and aortic arch. Open surgical repair may also still be the preferred option for repair of isthmic aortic injuries in stable or young patients. Open surgical repair is typically done Pre-contrast images can be helpful in identifying felt pledgets." Cristina answered quickly.

"Very good, Yang, what can you tell me about pledges that can occur and kinks in the graft?" Burke concentrated back on his surgical field. Cristina remembered reading something like this in the literature she's found in Burke's apartment. "Kinks can be seen within the graft material but are usually of no clinical consequence. Felt pledgets can be used to reinforce the anastomoses or to repair aortic cannulation sites. Felt pledges are high attenuation and can be confused with a small pseudoaneurysm." Cristina answered. Meredith on the other hand, looked at what Burke was doing at the moment. This was good. And what was good as well was that the patient is stable, for now at least.

They did, in fact, use one of the pledges to repair one aortic cannulation site. Besides the situation in the beginning of the surgery it has been completely okay.

After another hour, they were ready to close him up and get him to post anesthesia care unit for further monitoring until anesthesia wears off and they can start normal sedation to keep him from experiencing pain while recuperating. "Grey, you monitor his post-op status."

Meredith obeyed, what else is she going to do if not that?

"Yeah, I will do as you say." She said, taking the patient chart. After some time they decided it was time for him to be transferred to cardio intensive care unit.

Meredith was sitting at the nurses' station where she was able to monitor everything. The cardiac monitors were very good visible from point. The patient had a Swan Ganz Catheter to monitor his hemodynamics that can be left in place for now. Meredith's left the intra-pericardial catheter in place after securing it to the skin using sterile procedure and attached it to a closed drainage system via a 3-way stopcock that's going to be removed in 1-2 days. She knew they were supposed to a repeat ECHO tomorrow. She periodically checked for re-accumulation of fluid, but so far everything was okay. The only thing was that Meredith was tired. "Ugh, I am so freaking tired." Meredith groaned as she glanced at the clock. It was 1 AM. It seems like the clock is mocking her.

In three hours she was supposed to attend pre-rounds and she had no idea how to manage that, she was barely keeping it together now. But what put her through the night was her endless dreaming of Derek, their devotion to each other and fantasies of them lying in bed at their warm, comfy bed, intertwined. She tried to think of Derek and her. When she was with him everything was shining. He makes her rise when she falls. He says she gets the rest of them to move forward but as far as she's concerned, Derek was doing just as much. She needs him by her side. She wished that he was here now, assuring her she could get through this night shift. When it was just the two of them, enjoying their togetherness – but right now that wasn't possible.

She did want to do this, Meredith snorted lightly. She should remind herself of this.

This was torturous. She wanted sleep. Fatigue crept over her and for a slight moment she closed her eyes, telling herself not to doze off. She had patients relying on her.

But she figured she'd be no use to them in an overtired stressed-out mode when there is a medical emergency which can happen in trauma patients. She had to say she was horribly tired. So tired that she might sleep right there. She wanted Derek, an empty on-call room, him putting her arms around her and cradling her to comfort her. He kissing her until the world stops and it's only them blocking everything else out. But that was just dream thinking, not the reality she was in. Coffee, she needed coffee and a snack to keep her blood sugar up. Suddenly, she nodded off for only seconds only to wake up to the worried face of a neurosurgeon looking at her.

Derek was shocked at the view of her small, petite frame and instantly knew she was overtired and lagging due to the lack of sleep.

"Derek." Meredith got out and was getting up. Or at least she was making a motion to get up, only to lose hold. But now the overstress, the exhaustion and tiredness was all creeping up in her all at once. She swayed and Derek was there and catched her when her head landed on his chest. "Sit down." He ordered as he felt her pulse.

Meredith obeyed relentlessly. "When was the last time you actually ate, Meredith?" He asked quietly but in a tone that told her he was concerned. "Yesterday morning, I think." She answered warily. "Damn foolish girl." He cried out loudly resonating. "This is what I was talking about when I agreed to let you take night shifts, Meredith. Think about hydration and eating. At some point your body will give in, if you keep this up. Not to mention the fact that your blood pressure is going to bottom out, it's already low, Mer."

"I'm just really tired. Don't get carried away, I am fine." Meredith protested in a lame attempt, although she knew Derek was right.

She probably looked like hell on earth.

"Tired from the lack of food or what? You being fine is always alarming." He mumbled ironically under his breath. Of course he was concerned about her pale complexion that practically screams 'I need my sleep.' Meredith forced herself to keep her eyes open. She can't afford falling asleep when she was supposed to monitor this patient. "Stay here, in this chair and don't move. I'll be right back with a snack to get your blood sugar up and coffee." Derek watched her frail frame for a moment, before making sure she gets something into her stomach. Only minutes, if Meredith was honest it seemed like seconds, Derek was back carrying a stack of paperwork he needs to go through tonight and Meredith was stuck here he might as well do it here where he can supervise Meredith and trick her into eating to stop her blood sugar levels from getting dangerously low. He put a bottle of water, a power bar and a sandwich from the vending machine in front of her. He brought coffee for himself, water for Mer since he knew it was better for her. "Eat this." He ordered her.

"You're bossy. I like that." She smiled at him as her gaze went back to her patient's heart monitor. It showed a regular sinus. "Eat." He pushed the food to her. Meredith's brows furrowed at the view of the food. Her stomach rumbled, telling her to eat.

"I won't leave you prior making sure you're not passing out."

He seemed genuinely worried. "I'm not, Derek. I'm just tired, deathly tired and I'd love to sleep but if my patient codes and I am not here then I am done. I would look like a complete moron who can't monitor her patient. I'm supposed to be able to do this." Plus it would be a satisfaction for Izzie. But she didn't say the last sentence. He doesn't need to know that. But before Derek could reply in any way, Meredith unpacked the sandwich and started eating. Once again, Derek was amazed by her eating skills. After she finished, she offered him a small smile before saying: "I think I needed that. I didn't even know I was hungry until you shoved the food into my face." She giggled slightly. On Derek's face was a trace of smile visible, his eyes sparkled as he looked at Mer and put his around her.

"Derek we're at work." Meredith halfway protested. "You know you can't resist. We all know it and besides, no one's here besides you and me." Meredith relaxed when she felt him near her. "The patient maybe, you don't know if he can." Meredith blinked, slightly confused mixing with barely noticeable irritation coming from her.

"Who is conscious and able to see what we're doing here?" Derek made a pretty good point.

And so he stayed 'cause there was nothing better to do right now. The paper work he could do there too. That wasn't a problem. "Sleep if you want to." Derek offered. "I'm not going anywhere right now."

* * *

The next morning, Burke was sitting in the cafeteria, a tray with food on his left side and he was concentrated on the paper in front of him. He was reading about clinical trials concerning the replacement of aortic valves via TAVI, Transcatheter Aortic Valve System in extreme-risk patients. He just happened to be treating someone like this, who wasn't a suitable candidate for a conventional repair with sternotomy. The risks were just too high for that. He was reading through the results of a clinical trial concerning Aortic Valve Implants without sternotomy. They've released the 24-Month results. They were good, good outcomes in extreme-risk patients, excellent and sustained hemodynamics and no significant post-procedural aortic regurgitation. Maybe he should contact someone who had done something like this before. But this might be an option for his 78 year old patient with severe symptomatic aortic stenosis.

He was so concentrated that he didn't hear Cristina coming to his table.

"What are you reading?" She asked as she tried to grab the booklet Burke was reading in, his laptop was also standing there, meaning, he did medical research about something.

"Cristina, I am working." Burke told his girlfriend whose gaze was lingering on him. "You're reading." She noted. "An article about Transcatheter Aortic Replacement in high risk patients and I need some peace and quiet to accomplish that. If you want to sit, fine, sit. But be quiet. I'm researching something." Cristina frowned, that sounded vaguely interesting.

If only she knew what he was researching, then it would be a hell lot more interesting.

"You are doing medical research about what?" Cristina wanted to know and slouched down on the chair, not letting her eyes off Dr. Burke. "Transcatheter Aortic Valve Implantations – I have an extreme-risk patient who isn't suitable for normal aortic replacement and now I am looking into other options." He looked onto his watch for a second. "Don't you have pre-rounds, Dr. Yang? Bailey isn't someone who lets people do whatever they want." He smiled lightly before taking a big sip from his cup. He rubbed his eyes for a moment. He had been here since yesterday.

He did a pulmonic valvuloplasty and a CABG before he was called to an emergency patient with extensive trauma to the chest, both aortic and lung injuries. Both Cristina Yang and Meredith Grey scrubbed in on that procedure. It has been a long and very bloody surgery.

But right now the patient was in CICU and Grey was monitoring his vitals.

He sighed.

This was going to be a long day and a longer night.

And he was on call for next night.

"Right, pre-rounds, but … are you doing this, a TAVI? I'd love to see you doing one in this OR." Cristina was out for surgeries. Burke let out a chuckle. This was so Cristina-like. "After I talk to some experts, I'll think about it." He said cryptically. "I have to go, as you pointed out before I have pre-rounds and Bailey will literally kill me if I'm late." Cristina got up and jogged toward the locker room.

Derek was sitting with Meredith but at some point he was paged to some patient of his. "Are you sure I can leave you alone, Mer?" He'd asked with glimpse of worry in his eyes. But her condition wasn't that worrisome was it? "Yeah, sure. I'll be here sitting and monitoring my patient." She shrugged it off. But she hasn't slept. "You have pre-rounds in thirty minutes, Mer. Bailey won't like you skipping pre-rounds." "If she doesn't like it, she should take it up with Burke who ordered me to monitor this patient." Meredith shrugged and suppressed a yawn. Twenty-five minutes later, Meredith was still sitting on a chair at the nurses' station and was monitoring the trauma patient. For now, he was stable but she was worried about his blood pressure. They barely have been able to get it to a point where it could be considered as stable.

In this moment, she noticed his BP was tanking, his ECG was going into a wide-complex arrhythmia. It means VT until proven otherwise.

She got up from her chair but before she could make it to the room, she heard the heart monitor beeping erratically in distress. He was going to go into cardiac arrest.

That's not how she imagined start her shift.

"Oh no, this can't be …!" Meredith exclaimed as it dawned on her what she was in for, of course this was happening during her shift. Then he started crashing, the patient's state took yet another dive downward. This was so not good. It was not good at _all_. But Meredith Grey can handle running a code without freaking out. Maybe he was tamponading again.

She jumped up, sprinted into the room at record speed, a nurse who watched this was following too and was pushing the crash cart into the room. "I'll get the crash cart right away." She called out. Then she pushed to button and a computed voice said over intercom repeatedly: "Code Blue, ICU. Code Blue, ICU." Meredith didn't listen anymore.

She had more important things to do right now.

She quickly analyzed the rhythm, seeing it was a ventricular tachycardia. Ventricular tachycardia (VT) is ≥ 3 consecutive ventricular beats at a rate ≥ 120 beats/min. Symptoms depend on duration and vary from none to palpitations to hemodynamic collapse and death. VT of short duration or slow rate may be asymptomatic. Sustained VT is almost always symptomatic, causing palpitations, symptoms of hemodynamic compromise, or sudden cardiac death.

It was a polymorphic "sustained" VT (lasting more than 30 secs) and the patient is hemodynamically unstable.

This wasn't good. Meredith would have to do an unsynchronized cardioversion or defibrillation on her own. Unsynchronized cardioversion (defibrillation) is a high energy shock which is delivered as soon as the shock button is pushed on a defibrillator. This means that the shock may fall randomly anywhere within the cardiac cycle (QRS complex). Unsynchronized cardioversion (defibrillation) is used when there is no coordinated intrinsic electrical activity in the heart (pulseless VT/VF) or the defibrillator fails to synchronize in an unstable patient.

Meredith grabbed the paddels, the patient already had percutaneous pacing pads applied to his chest.

"Charge the pads to 120." Meredith ordered, calmly.

"Charge. Clear."

The nurse pressed the button.

She pressed the paddels against the patient's chest and waited for the heartbeat to normalize itself. The shock sent the patient's body flying upwards. But the first loop wasn't successful, Meredith realized. She'd have to repeat this. She was using a biphasic defibrillator device.

"Anything?"

"No, nothing." The nurse replied as she focused on the monitor.

Meredith shook her head in desperation. "Charging. Nineteen seconds." The nurse pressed the button who is for the second round. "Charge them to 200." Meredith called out.

"200. Twenty-seven seconds."

And this time it worked. The patient was good. "We've got him back." Meredith said as relief was flooding through her body. The cardiac monitor showed a normal sinus rhythm. That was good.

After she got the patient stabilized, she put him on Amiodaron prophylaxis to keep it from happening again.

She singlehandedly saved this patient. She could be proud of herself.

Meredith was, she felt pride over her save. She did that, gave him a second chance. But what about his brain, is it okay? They would need to do further studies to find that out. He'd been oxygen deprived for a long time, the time in which his heart wasn't beating. Maybe he could have brain damage.

Maybe, there was a possibility. Meredith knew that. She was aware of the odds.

_Anoxic brain injury_.

Bailey asked her about that yesterday.

"Can you take over for me now that he's stable? Page me, Dr. Burke or Dr. Yang if there are any irregularities in his heart rhythm or change in hemodynamics etc. I have pre-rounds." Meredith explained and for once nurse Debbie just did what she was told to do. Meredith jogged to where she knew Bailey and the rest of her group would be. When Bailey heard her, she turned around, a bit agitated by her intern being late.

* * *

"Grey, where were you? You missed pre-rounds." Bailey accused her. The other interns were standing around in a circle as Meredith got her lecture. But she hadn't skipped pre-rounds just because she didn't want to attend to pre-rounds but because her patient had been flat-lining for a prolonged time. They would have to see whether her patient would be okay or if he had sustained anoxic brain injury due to the *Now-Flow-Time* that occurred even though Meredith tried to be as quick and productive as possible all at once. But she had been on her own. "I was just doing my job since a code blue always comes before pre-rounds or rounds." Meredith noted, she couldn't keep herself from smiling. "Your patient coded?" Bailey asked with furrowed brows. "And there was no resident to run the code?" She asked in a harsh voice. "I'm almost a resident." Meredith reminded her, before nodding.

"My patient coded and I was alone and I had to do every single thing all by myself, so sue me if attending to pre-rounds wasn't priority number one." Bailey made a hand motion that was telling her that she'd done everything right. Pre-rounds weren't as important as patient care and emergency bedside procedures, in her case. "How come he was coding? And why wasn't I paged?" Cristina questioned. "I would have dropped everything and come to help you." She said. "There was no time for me to page anyone. There were no nurses around and I needed to minimize No-Flow-Time because the brain does need oxygen."

"We know, Grey, we're all doctors around here." Bailey said.

"And the patient is stable again?" Bailey asked, her brown eyes were eyeing Meredith attentively. "Last time I checked, Mr. Brown was stable as was his blood pressure after some infusions to stabilize it. He seemed hemodynamically unstable." Meredith told her, she was able to assess and treat a patient on her own.

Cristina's mind shot backwards to a similar experience, but this time it wasn't some random patient it was Meredith. She looked at her friend, trying to replace the picture of lifeless, cyanotic Meredith with the Meredith who was standing right in front of her and was standing up to Dr. Bailey.

It worked and slowly Cristina's breathing returned to normal. Nobody noticed the change in her breathing and she was glad about it.

"So you will get your assignments." Bailey announced. "And you won't harass Dr. Bailey or any other colleague for that matter. I repeat, do not harass Dr. Bailey. Stevens, are we clear?" Stevens wasn't attentive and caught talking with George who didn't really reply but stayed silent in an attempt to listen what Dr. Bailey says. Stevens didn't answer. Bailey cleared her throat, loud enough for Izzie Stevens to hear. "What did ya say?" She asked back without much enthusiasm in her voice. It sounded like she was bored. Meredith couldn't help the feeling that Izzie wasn't cut out to be a surgeon. Maybe she didn't have what it takes.

"'kay, Grey and Yang, cardio with Burke; Karev is with Sloan on plastic."

"Wait, what?" Izzie interjected. Bailey frowned almost instantly, her body was practically screaming 'what the frigging hell is this girl thinking that she can't understand a simple sentence. "She's once again getting all the good cases …" She complained as she saw that Meredith was assigned to Dr. Preston Burke, cardiothoracic surgeon of Seattle Grace. Meredith really didn't get her. Meredith Grey was off neuro and she still was complaining. Dr. Bailey looked like she was absolutely thinking the same. "O'Malley, you're on Dr. Shepherd's service since he could use an intern. Stevens, pit." Bailey told her interns. Meredith and Cristina made their way to Dr. Burke who seemed to be headed to a patient room. "But Dr. Bailey, isn't it possible that any other attending needs a helping set of hands?" She practically begged for not having to spend a second day down in the pit. "Stevens, your job is it to make me happy. Do I look happy to you? You won't see the inside of an operating room before I look as happy as Mary-freaking-Poppins." Bailey gritted out through her teeth.

Stevens was a really challenging intern with less potential than others like Grey and Yang who always were on top of their game. Even Meredith never showed any weakness, not that that's good but it was less annoying and time-consuming than Stevens. Well, Meredith was challenging as well but that has other reasons Meredith can't do anything about. "Do you understand me?" She asked, seeing if Izzie was getting it with full clarity. "Yes, Dr. Bailey." Izzie said, deeply hurt in her ego. Shepherd had her doing charts and now Bailey was torturing her with a second day of stitching up in the pit. Izzie turned around and headed for the elevator. Alex was following her for a moment. Both of them entered the elevator, and were riding it in complete silence and Izzie appreciated this. Suddenly, the elevator came to a hold. Someone had pulled the emergency button to stop the elevator. Alex frowned, what does this mean? Who was she stopping the elevator? Alex knew from Meredith that she and Derek sometimes used that button to have some dreamily moments in the elevator but not for this … "This is not fair." Izzie vented, hoping Alex would be there to console her but since his outburst in the OR gallery she didn't think so. "Would you please just stop hitting the emergency button for no reason? I need to get to Sloan who will skin me if I'm late." He ranted, blended by Izzie's annoyingly persistent ignorance.

Izzie snorted. "All you're gonna do is pitching him muffins and his beloved coffee. It's all you're gonna accomplish." Izzie replied snarky. Alex was getting irritated.

"Just stop blocking the elevator. Here are lives that need to be saved. If I were you …" He silently completed that sentence. *I would not be complaining about such small things, especially with your history of being Drama queen and not to mention the heart you stole for Denny. Meredith always stood by your side despite everything. I suggest you do the same. But honestly I'd be surprised if she won't throw you out over short or long considering how you behaved toward her in the last few days, this kind of behavior isn't really acceptable.* But of course Alex didn't say that. To be frank, he didn't give a shit about Izzie and how this'll play out for her. She's been digging her own grave. "If I really wanted your advice or a lecture I'd say so but until then would you just shut it." Izzie snapped at Alex who just shrugged.

He didn't really care, maybe at some point he did but what she did to Meredith is the end of the straw. The way she was devaluating Mer who didn't do anything to provoke that kind of behavior. He was extremely thankful that the elevator started moving again and he was no longer forced to stay with Izzie in one place without a window and therefore without escape route. He then made his way to Mark Sloan who was waiting for him impatiently.

"Where were you, I've been waiting for you forever." Alex murmured something incoherent as he was reporting to his attending for the day.

"I was stuck in the elevator. I didn't initiate all of this." "Okay, then. It does not matter. I have a kid with a cleft palate, I'm probably scheduling that for tomorrow. You're scrubbing in, Karev." "I am actually scrubbing in on an actual plastics surgery? You aren't kidding, right? 'cause it's not fair to mess with someone's head like this." Alex answered. Izzie had been completely wrong and he was glad about it.

"I'm not kidding, Karev. Go prep. And I also have a Rhinoplasty scheduled later today at 4 PM." Mark chuckled at his surprised face expression. Alex couldn't believe it. Sloan was actually letting him scrub in on a surgery.

* * *

**A/N: Please review.**


	39. Chapter 39

**Chapter 39**

* * *

** Doctors live in a world of constant progress and forward motion. Stand still for a second, and you'll be left behind. But as hard as we try to move forward, as tempting as it is to never look back, the past always comes back to bite us in the ass. And as history shows us again and again, those who forget the past are doomed to repeat it. Sometimes the past is something you just can't let go of. And sometimes the past is something we'll do anything to forget. And sometimes we learn something new about the past that changes everything we know about the present.** New History; Meredith Grey

* * *

Meredith and Cristina made their way to Dr. Burke while chatting about something. "So why didn't you page anyone? He was my patient too." Cristina asked as they walked. "It happened very suddenly. There wasn't anyone who could have paged you or Burke. I could have done it, certainly but then my patient would have been dead by now, probably." Meredith only replied. She hoped Cristina would understand. And miraculously she did. Cristina nodded, that sounded plausible. "I will make sure, though, to remember paging the both of you should this happen again." Meredith added as they both walked over to the Nurses' station. Dr. Burke was already waiting here. "Good." She simply said as she started walking faster. Meredith tried to catch up with her pace as they both stopped when they saw Burke. He saw them as well. "Dr. Grey, Dr. Yang. Nice of you join us into medical future. The first Transcatheter Aortic Valve replacement is going to happen today." "So we're watching you doing a TAVI?" Meredith stated. Maybe she should have decided to do that procedure. Maybe then she wouldn't have almost died on several occasions, she thought to herself. But does she count as an extreme-risk patient?

"Yeah, I am planning to do a TAVI on an extreme-risk patient who doesn't meet the criteria to undergo conventional procedures. So I've started looking into other options and I did a few calls to find out about this procedure." He said, as he handed the chart over to Cristina who opened the patient chart and skims through it.

"Wow." She exclaimed after she started reading.

"That's one hell of a chart. This patient has a telephone book-alike chart, I mean look at the co-morbidities." Cristina exclaimed, looking over some doctor's handwriting. Meredith tried to catch a glimpse but so far she wasn't very successful.

"There's no way this patient's surviving being put under general anesthesia. How do you plan on replacing the aortic valve?" Cristina questioned, showing that she was interested in learning new surgical techniques. "There is always the possibility of doing catheter-interventional." Meredith noted.

Cristina looked up at Mer for a second.

Meredith barely noticed this.

Then she bowed her head and started to read through it, before she was giving the chart to Meredith who also needed to have the chance to look through the chart before entering the patient room. "Although, maybe I should have thought of that when I was in that situation, maybe I could have avoided the surgery with being put on bypass and all." Meredith brooded over the past. Maybe ...

Cristina shot her a worried look but Meredith didn't notice.

"Grey, you're supposed to be focused." Dr. Burke's harsh comment on her lacking attention brought her back to reality. Meredith regained her senses and focused on what was important. So she asked Cristina for the chart so she can take a look as well. "Can I see the chart please, Dr. Yang? Would you mind sharing it with me so I can get a look as well?!" Meredith asked in a friendly but professional voice. Cristina seems to have finished reading through it and closed it, Mer happily registered.

"Sure, here." Cristina said as she handed her the chart.

"Thanks." Meredith answered before opening it. Meredith opened it and was looking at words like past smoker with a history of COPD and heart failure NYHA III with BVA implantation. EuroScore index of 24,1%." She read aloud, "Wow, now I get why you won't do a normal aortic replacement." Meredith said. "The patient asked me to find something that can bring her relief." Burke said. "She was admitted two days ago by her healthcare practitioner due to worsening dyspnea and presyncopes." Meredith read aloud as she read through her chart.

"How would you proceed?" Burke threw the question into the room after seeing Meredith has finished reading as well.

Meredith was the first to answer.

"I would order a MSCT scan evaluation maybe, probably a TEE to confirm things." Meredith suggested after her brain processed the question. Cristina looked at her for a moment, how come Meredith knows all that? It's cardio. Maybe that's the reason. That it was cardiology. Meredith took Burke's straight expression to continue speaking. "To get a better view of what to expect, to see if the annulus or the LVOT is enlarged which complicates it." Finally, Dr. Burke made a motion, he nodded and then said toward Grey.

"So thanks, I guess we have had enough of an education, Dr. Grey." Dr. Burke dismissed her with a half-smile on his face.

At least he got two interns who actually knew something. Meredith didn't miss his half-smile. "Let's go see the patient." He announced and turned to go. Cristina and Meredith followed their attending to the patient room. "Good morning, Mrs. Rodriguez." He announced brightly.

Cristina and Meredith exchanged looks.

The patient has been knitting before the doctors entered the room but now she was putting away her knitting and smiled at the doctors.

"Good morning, so many doctors." She exclaimed while looking at the three of them. "I'm Dr. Burke, the attending on your case and those two, Dr. Yang and Dr. Grey are going to assist me in surgery." He shortly introduced himself and his interns. "Oh, that's nice." She commented. Dr. Burke cleared his throat. "Dr. Yang, present the case, please." He ordered while standing back. Meredith on the other hand was getting ready to take a listen to the patient's chest. "Can you sit up for me so I can take a quick listen, please?" Meredith asked in a friendly voice.

The patient slowly sat up without replying anything.

The patient was an elderly woman in her seventies with grey hair and a friendly smile. "So how are you gonna fix my aortic valve?" The woman asked. "It seems it won't be getting better without the surgery, my doctor told me." She said. "Are you really gonna slice open my chest?" The patient asked, frowning at the thought of that.

Meredith stepped forward and said in a comforting voice: "We probably won't perform a conventional surgery you are talking about. We think the TAVI is a better option and it's most likely more safe for you." Meredith smiled reassuringly.

Dr. Burke was standing in the background, letting his interns manage the patient interaction. "It simply means we're going in through your femoral artery, and thread the catheter with the valve through your arteries to your heart and then we're gonna replace the aortic valve. It landed successes in patients with extreme-risk for a normal procedure. We're strongly recommending you choosing this option." Cristina jumped in. "The advantages are shorter recovery time, it's also less invasive. It's pretty much like a normal heart catheter, just that it's gonna take longer." Meredith added.

The patient looked relieved by not having to go to such a painful and excruciating recovery. They were opting for another option. After thinking this over, she slowly nodded.

She'd decided. "Yeah, of course if you this is the right to choice then I'll do it." The patient sighed.

Cristina nodded apprehensively.

The patient still looked unsure. "Okay, Dr. Grey and Dr. Yang are an excellent team of doctors who will be assisting on your case. They gonna take you to get your MSCT scan so we can get a better look of what's going on inside and they gonna do an ECHO and some additional studies before I can review the results and we're all set for tomorrow." Burke cut in. The patient stared at him with a blank expression.

"Tomorrow, you're gonna operate tomorrow?" She asked.

"But I … there are people I need to tell about this and I am pretty sure my grandchildren want to visit. I'm sure my daughter will be coming by at some point and bringing them with her. They're four and six. One boy and one girl." She bragged about her grandchildren. Cristina and Meredith exchanged views for a slight moment, no one noticed.

"There will be plenty of time after the exams." Dr. Burke quickly reassured his patient. "The TAVI is scheduled for tomorrow. So if you have any questions just ask Grey or Yang here." Dr. Burke said.

"I mean there are risks to every surgery." The patient mumbled. "Maybe we should call this off." Cristina looked over to Burke who looked alarmed.

This wasn't very good. The one year survival rate of a severe aortic valve stenosis and already manifested symptoms is only 50% which is quite unfortunate. And this patient showed symptoms already. Surgery really was the best option in this case. Dr. Burke stepped nearer to the hospital, trying to think of a way to woe Mrs. Rodriguez back to get the surgery. Even if she didn't saw it, she needed that surgery.

"Mrs. Rodriguez, I'm afraid not doing the surgery would do more harm than good. You have severe aortic stenosis. Not doing anything would put you on risk for sudden cardiac death which is common when straining too much in those situations. Your heart could stop in a matter of seconds. You need this surgery, Mrs. Rodriguez." Burke tried. "You wouldn't last a year." Cristina interjected, insensible as always. She was very blunt with her patients, just like that she was telling her the prognosis if there is no surgery done. "Cristina." Meredith hissed scolding. Cristina rolled her eyes.

The patient now had her attention on Cristina Yang.

"You say I am most likely gonna die if I don't have the surgery? Is that what you're saying?" The patient shrieked. Dr. Burke was forced to step in. "Unfortunately it occurs that Dr. Yang is right in saying that. Half of the patients with severe aortic stenosis who are showing symptoms die without intervention."

"I am gonna die without it?" The patient noted.

"Look at the bright side. You won't have to go through the excruciatingly painful recovery that comes along with an open procedure." Meredith gave her input, immediately sensing Burke and Cristina's gazes lingering at her. They knew she wasn't kidding. She'd been through that.

"Sounds like all of this, sounds not so new to you."

"You have no idea." Meredith let out a chuckle, remembering the pain after she'd woken up from the anesthesia, she'd wished the pain meds would have knocked her out again. Being a patient sucks big time. "This is not really the first I heard this." Meredith added, smirking to herself.

Cristina and Burke were both watching Meredith interact with the patient. Meredith knew she shouldn't personalize this but sometimes she just couldn't help it. This is why she can't go into cardiothoracics. She'd be reminded of herself and her medical condition every time. It would be a constant reminder. She'd been dealing with a sick heart all the way through her life, in her personal life. As interesting as cardiothoracic surgery was she just can't do it, or pediatric surgery for that matter. Both are specialties she generally likes but not on a constant basis. This is why.

"So you had your aortic valve replaced?" Meredith cringed internally.

Cristina was waiting for her to answer. "How'd ya know?" Meredith finally stuttered embarrassed, she was caught by surprise. Burke would kill her just as he would kill Cristina. The elderly woman let out a chuckle before answering. "Sweetie, I've been alive for a very long time. I can sense certain things, all I needed were a few hints. First there was a comment about the painful recovery. That makes me think you know because you've been through it, that's why you've chosen those words …" The woman concluded. Meredith groaned inwardly. Was this so obvious? She was royally screwed.

Meredith threw a scared view over to Burke, trying to sense whether he was angry at her as well for not shutting up about it.

"Look, I know your situation right now isn't the best, but we are qualified to do something about it." Meredith said finally, trying to get the woman to rethink her decision. "Yang, a word outside, please." Dr. Burke gritted out through his teeth. He needed to have a serious word with Cristina. She can't talk with patients like that. Cristina held her head down. She knew she's made a mistake with telling that patient what she knows is true. Some things are better left unspoken. After that, both interns and the attending left the room.

Meredith was preparing for punishment, especially with the patient noticing from her words that she's been through that. "Dr. Yang, I need to have a serious word with you. You can't speak to patients like that, at least not that bluntly. We all want her to have the surgery but pressuring her into it isn't going to anything good. You really need to improve your bedside manner, Yang." He said coldly before turning to Grey. "And you need to learn how to keep private things private. You don't have to tell everyone who walks over your way about your medical history, Grey. That I know yours, is ... I don't know." Well, you've operated on me, dumbass. Meredith thought. I never wanted to say anything in the first place but the circumstances did that. I hadn't had a choice in that matter. But she never said it aloud.

"Well, I just hope you won't speak to me like that when I have an appointment for controlling the pacer setting." That was all Meredith said to that.

"Of course I'll be nicer than I am right now because then you're my patient but today you're my intern to was stupid enough to hint enough to let this woman in there figuring out what was going on. Fix that, Grey. Now, do the studies if you think you will be able to do it." Burke yelled at them.

Cristina and Meredith exchanged views.

Then he walked away. "This was harsh." Cristina was the first one to speak. "Yeah, harsh, you could definitely say that. That was more than harsh."

"Let's go, prep her for the MSCT." Cristina said as she knocked and reopened the door. The patient looked up. "You were just here before." She noted. "Yeah, we were doing rounds." Meredith answered with a quiet laugher. "Now we need to do some studies. We start by doing the echocardiography, then we'll do a short-term ECG and then we're gonna move on to do the multi-slice computed tomography." Meredith explained. "Just go on, I am used to being poked and prodded." The elder woman replied with an interested face expression as she continued to eye Meredith.

Meredith did try to not show that she knew she was being watched.

Cristina pulled up the portable ultrasound machine and asked the woman to free her upper body. Before Cristina started the ECHO, Meredith took the patient's blood pressure. The values were a bit high. They knew their patient was taking medication to get her blood pressure down.

"This might be getting cold." Cristina warned her before she put the transducer on the patient's chest. Soon there was a beating heart on the screen. "Sweetie, I know that, this isn't my first ECHO." The woman only replied. Cristina rolled her eyes but she couldn't see that because she was lying on her side and was staring onto the wall. After they also did the short-term ECG, they paged Dr. Burke and pushed her bed through the hallways to get her down to Cardiac Imaging.

"Wait, Cris. This is gonna be a long day."

"Quit rambling, Mer." Cristina just said, interrupting Mer before they wouldn't get anything done.

"I just ..."

Meredith inhaled before continuing: "I just wanted to ..."

"Just say what you want straight out." Her person added while rolling her eyes, grumbling.

Meredith's ramblings were all too familiar to her.

"Do you mind me to go get coffee for both me and you?" Meredith asked straight out, both of them knew that this wasn't the only reason. For some reason, Mer knew that Derek was on the same floor. Both her and Cristina knew it. But no one said it. Mer was glad for that. Cristina shook her head.

"Not at all. Go, Mer. But don't be so long- Burke won't like catching you making out with McDreamy."

Only Cristina knew her that well.

* * *

Derek Shepherd and George O'Malley just entered a patient room only to be greeted a woman in her fifties. Derek smiled shortly before going over to teaching mode. "This is Dr. O'Malley who will be assisting today." "Hi, it is nice to meet you. I hope you're the best." The woman said, addressing Derek, almost threatening him. "You won't find someone better. I am great at what I do." Derek answered. "Dr. O'Malley." He said. George had been familiarizing himself with the chart before entering the patient room. "This is fifty-three year old Cora Laurenstein, presenting with seizures, extremity weakness, difficulty speaking, visual field deficit and a persistent headache. She also has a genetic condition called neurofibromatosis type 2, a rare, inherited nervous system disorder." Dr. Shepherd nodded, knowing what this could mean. He already had a suspected diagnosis in mind but wanted to wait for what the MRI says.

"I've been experiencing this pain for weeks now. So I went to see a doctor. Plus, my vision's pretty funny, it's really blurred, I can't really see anymore." She laughed nearly hysteric.

George O'Malley stood back while Derek pulled out a lamp to test the function of the pupils. He shone the light into her but there was no pupillary response on one eye. "I … I can't see on the right eye." She repeated. "O'Malley, schedule her for an MRI and a CT, make it as fast as possible." Derek ordered without turning around to him.

"Let's just stay calm until we know what it is." Derek said.

"You think it could be a tumor." Her features darkened immediately.

"Let's not worry until we have to." Derek flashed a short smile, knowing she wouldn't be able to see this anyway. When O'Malley and he were out of the room, O'Malley started asking questions: "You think a tumor is the cause of this, right?" Derek curtly nodded. "Let's wait until we have the scans." He said.

"Just so you know, I don't support Izzie's behavior toward Mer, I am not. I thought I should tell you that?"

That sounded like a freaking question.

Why's that?

Something in that angered him, even if only a bit.

Soon they took their patient to get the MRI. While they were waiting for the pictures to come up ... they were talking. "How instead of telling me you show it to Meredith that you care about her? Why don't you do that?" George quieted down instantly as the neurosurgeon growled at him, infuriated by the mere thought of Stevens being mean to Grey. He wasn't like the dreamy Derek they normally knew. Who was leaning against walls, with the perfect hair and all the hairproducts. Now he was in angry-protecting his girlfriend-mode.

Derek's jaw clenched, he was frustrated.

They were at work. And George was just his intern/ roommate.

"Why don't you go picking up the patient's labs." Derek suggested, running his hand through his hair.

George was startled by his harsh voice. "Ye ..." He stammered helplessly. Sometimes, the neurosurgeon attending was scary. "Yes, I am going to go do that right now." He rambled. Derek pinched his nose before interrupting the babble of the intern. "O'Malley." He raised his voice. Finally, he went to get the labs.

After two hours, they finally were able to look at the films that were showing a brain.

"They're coming up." George suddenly exclaimed as Derek sat on a chair, his feet on the table. It was just him and O'Malley here and as soon as he heard that he sat upright.

O'Malley was right.

"See that right there?" Dr. Shepherd was pointing at a tumor. Meningiomas grow from the dura covering of the brain. As the tumor grows, it compresses and displaces normal brain tissue, increasing size of the tumor, pressure and swelling cause neurologic symptoms. George immediately saw it. "It's a convexity meningioma. It's been there a long time. These tumors don't produce symptoms until they reach a large size." Derek said, explaining. "This tumor has a size of diameters of 2 inches." "But that's five centimeters." George said, pointing toward the screen. "Two inch tumors are not uncommon." Derek only replied. "Now we just have to figure out the right approach.

"So it has been there for years, maybe? Now we've found it practically incidentally?" George asked, frowning. Derek nodded without taking his eyes off the screen.

"What can you tell me about meningiomas?" He suddenly asked. George should have known that was coming. It was bound to happen. He searched his brain for information on meningiomas. "O'Malley, I asked you a question." He questioned. "I …" He stuttered. "Surgeons don't stutter." Derek groaned inwardly. He wanted Meredith and he was sure that that was based on mutuality. She wanted to be on his service for sure.

Why wouldn't he want to work with her?

He wanted to.

But he has to teach the other interns as well (even if he thinks they're being idiots).

But Meredith on the other hand ...

... she was sharp, inquisitive, talented and good with patients.

Derek sighed.

Before he turned his attention back to the magnetic resonance image on his computer screen he was supposed to evaluate before talking to the patient about treatment options and all ...

But apparently, his thoughts went back to Mer momentarily.

She was great to work with, not only because she was his wife but because she had it, the drive and all.

"Symptoms of a meningioma vary by location and size of the tumor. They often first appear as headaches and seizures, primarily due to increased pressure of the growing tumor. Weakness in the arms or legs, or loss of sensation, may occur with spinal cord meningiomas." He finally started talking.

"What is a meningioma, first of all, basics ... Remember the basics, O'Malley. That's important." Dr. Shepherd told him with a serious face expression. He'd rather be teaching Meredith right now. She'd at least understand what this is about.

"Meningioma is the most common type of primary brain tumor, and it's accounting for approximately 30% of all brain tumors. Meningiomas originate in the meninges, which are the outer three layers of tissue between the skull and the brain that cover and protect the brain just under the skull. Meningiomas grow out of the middle layer of the meninges, called the arachnoid. When they grow, they press against the brain or spinal cord." George answered, feeling slightly uneasy. Shepherd made him feel that way. He can be intimidating sometimes.

"What can you tell me about the location and how does that have an effect on the symptoms?"

"The location." While George was still pondering about what to say, he saw someone entering the viewing room.

"The symptoms can vary. The tumor can be located Convexity, it means on the surface of the brain away from the midline, then there's something called a Parafalcine meningioma that is arising the meningeal layer between the hemispheres of the brain, Posterior Fossa where the cerebellum is, Cerebellopontine angle meaning on the side of the brainstem and last but not least Olfactory Groove and sella where bony space where the pituitary gland is situated. Like I said before, symptoms can vary depending on location."

It was Meredith standing there and answering his question. George gaped at her with an open mouth. Derek formed a surprised smile but glad to see his wife on such short notice. "Mer, not that I am not happy to see you, I am but what are you doin' here?"

"I am waiting for the CT to get ready. They still have one patient to go before we can use it. So I asked Cristina if she minds watching the patient so that I can get coffee for us." She flashed a quick, conspiratorial smile.

She had two cups of coffee in her hands, one for her and one for Cristina.

"I assume she said yes."

"She did. Are you operating on that meningioma later today as you've figured out a surgical approach?" Meredith asked, her eyes glancing over the computer screen. She looked like she was a real professional. "Yep." He answered. Meredith smirked before turning to George. "You got lucky today, this isn't something you see every day. So take it in. I'll be in the gallery." Last sentence was directed to Dr. Shepherd.

"Looking forward to it, Dr. Grey." Derek smiled happily. He was the luckiest man on earth right now.

Suddenly Meredith's pager was interrupting the comforting silence.

"I have to, I kinda can't ignore the page. My patient is ready for CT." Meredith quickly left, running.

* * *

Derek looked at her as she ran towards Cardiac imaging. Cristina already prepared every and had the patient lay down on the gurney. The patient was anxious. "Is this safe, what about radiation?" "The amount of radiation you are exposed to is very low. Multi-slice computed tomography is a recently developed technique for assessing the function of the heart and the coronary arteries non-invasively so we can avoid putting you through two heart catheters." Cristina explained just as Meredith entered the room. "There I am. You can wait in the other room, Mer. I am just about to inject the dye …" As she said that she slowly injected something liquid into a superficial vein by a small needle placed either on the back of one of her hands.

Meredith obeyed without further questions and left the room only to sit down by the computers in the next room.

The Cardiac MSCT uses x-ray beams and a liquid dye to form a 3-D image of the heart and vessels. The scanning machine scans the heart very quickly. This provides sharp, detailed images that can't be achieved with other tests. They were looking for narrowing of their patient's coronary arteries. A CT scanner uses x-rays to scan the dye moving through their patient's heart and its blood vessels to create sharp, detailed images.

"The exam will only take a few seconds so when I ask you to hold your breath you do it."

Cristina knew they would have to wait until the dye reaches the coronary arteries. The patient only nodded. Meredith was waiting for the pictures and soon they were coming up.

Meredith waited for the pictures to come up and when they were she was calling Cristina over the integrated intercom.

"Cristina, the scans are up."

"Good."

Cristina pushed the button to get the patient out of the machine.

"I'm paging Burke now." Meredith's voice announced as she pulled out her pager and did what she said. This was giving them a more detailed view. Dr. Burke answered his pager call soon after they paged him. Cristina and Meredith waited for him to fully evaluate the scans. Without saying another word, Burke sat down to evaluate the scans, immediately becoming aware of the large anatomy. "The left ventricular outflow tract is enlarged, see?" He pointed towards the screen. Meredith and Cristina immediately saw what he meant. "There's also severe asymmetric calcification of the aortic leaflets." Also, he did some CT-based annulus measurements.

"So, now that that's done, I think we'd need to a transesophageal echocardography to confirm this." Burke suggested. Cristina and Meredith were looking at him expectantly, waiting for him to continue.

Cristina's hand flew up. "I'll go prep her."

Meredith chuckled quietly, no one seemed to notice.

They also did a TEE afterwards to confirm the large anatomy.

It uses high-frequency sound waves to produce a graphic outline of the heart's movement. Meredith and Cristina both watched while Burke was guiding an ultrasound transducer, that is positioned on an endoscope, down the patient's throat into the esophagus. An endoscope is a long, thin, flexible instrument that is about ½ inch in diameter. "Why are we doing this?"

"The TEE test provides a close look at the heart's valves and chambers, without interference from the ribs or lungs. TEE is often used when the results from standard echo tests are not sufficient, or when the doctor wants a closer look at the heart." Cristina answered as Burke asked her about that kind of procedure.

However, she had no idea why he would be asking about a standard test every intern was supposed to know about?!

After they did all the necessary testing, Dr. Burke let Dr. Grey and Dr. Yang inform the patient of the diagnosis.

When they exited the patient room, Meredith knew she needed to update Burke on his trauma patient. "Dr. Burke, can I have a word with you?" She asked. "It's about Mr. Brown." Dr. Burke looked up. "What did you do, Grey? Did you do something?" He asked, raising his voice to a higher pitched level. Meredith didn't seem affected by that, she just finished what she wanted to say. She knew she had to inform her attending at some point. "I didn't do anything except save this man's life. He coded and no one bothered to answer a code blue. They called out over intercom and no one came. He had suffered from V-tach. Precordial thump wasn't effective so I was able to cardiovert him back to a normal sinus and he's stable for now. He's on a longtime infusion of Amiodarone to prevent it from happening again." Meredith spilled what happened.

She hoped Burke wouldn't yell or anything, she did save the patient.

"Is he stable?" He asked the same question as Bailey did. "Yes, he is. I made sure of that. I wouldn't have left if he wasn't stable." Meredith confirmed, as usually turned into a ramble. Which Meredith does quite often and her superiors know that. "That's the reason for me being late for pre-rounds." She added, feeling the need to say this.

* * *

Burke yanked his scrub cap from his head as he continued to stare intensively on the OR rotation. The Chief was doing a trans-jugular intrahepatic portosystemic Stent-Shunt in OR 3, Bailey was the resident on the case. Derek was just finishing in OR 2 and was now joining him in staring at the OR schedule. Then he grabbed the marker, pushed Dr. Nelson's aneurysm repair back to put his Bentall-procedure on the board. The woman's condition was more and more declining and he was forced to push it up. He had no choice but do this. He smiled satisfied. But he had no way of knowing that Derek had watched his moves from behind. He was standing behind the nurses' station, making notes in patient charts as he walked up on him. "He won't like that." Derek said while smirking. He had seen Burke pushing the surgery of his colleague back. "I'm sure you won't tattle on me, Dr. Shepherd." Burke made a mocking remark as he continued to stare at the OR board.

"Nah, we're all grown-up here." Derek declined, half-laughing. "Apart from that, I will probably never be able to thank you enough." He looked down as he was suddenly very interested in the floor. Burke didn't know why he was so embarrassed at all.

He did save Grey's life after all. He and Cristina were allowed to take the credit for that, at least for the most part.

"It's my job, Shepherd. I do valve replacements and ICD implantations for a living. It's what I do. Hearts are my job. But before that surgery, I never felt so much pressure than then." Burke replied, he'd never operated on a well-respected colleague before. "Still, there's nothing that can truly convey how much this means to me. I'm sure you've noticed the changes. She can strain without getting problems with her circulatory system and she never lost consciousness after she completely recovered from all of it. Meredith is able live a fulfilled life." Derek told him.

"Well, that's something I'd describe a really good outcome of all of this." Burke nodded in appreciation. He was glad Meredith was doing so great. If he was honest, he hadn't been that optimistic when he'd first seen her MRI scans that were taken prior surgery and pacer implantation. Her heart had been enlarged, even if only a bit but enough for her to have to take certain heart meds.

"You did good." Derek added.

"You're giving me a compliment that doesn't consist of sarcasm?" Burke laughed in surprise. Derek frowned for a second.

"Hey, just because we're both in for the race to be getting the Chief-position it doesn't mean we can't friendly with each other. I mean it would probably be helpful considering Meredith and Cristina are practically glued together."

"They come as a pack." Burke agreed with his neurosurgeon colleague. "Any surgeries scheduled?" Burke asked, sounding vaguely interested in his colleague's schedule. "Oh, the attendings are meeting in front of the OR rotation? Can I join in?" Derek groaned at the sight of Mark coming their way. A cocky plastic surgeon with a big ego appeared behind them and instantaneously and simultaneously both of the surgeons turned around only to face a plastic surgeon with a mischievous smirk on his face. "Mark." Derek got out.

"What are you doing here?"

"Checking the OR rotation. I thought Shadow Shepherd was doing the aneurysm clipping in OR 1." Mark Sloan didn't recognize the awkwardness of him remembering a surgeon's scheduled elective procedures that is less talented. "You remembered his surgeries?" Derek asked in utter surprise. At some points Derek Shepherd really thought he was a lesser man for Mark knowing him. Like right now.

"Uh, I never really thought about it … not really." Mark avoided the neurosurgeon's question.

Out of blue, Derek heard footsteps nearing them. "Dr. Shepherd." The voice asked. "I need to ask you for a favor. I want your opinion on this brain tumor." Derek turned around and looked into the friendly face of his colleague, in front of him was Krychek, one of three senior neurosurgeons of Seattle Grace Hospital next to Weller and Nelson. "You need a consult?" Derek asked, turning away from the OR rotation, motioning Krychek to walk with him.

"Yeah, I'd be very happy to work with you on this Craniopharyngioma." The elder neurosurgeon said, wanting to flatter Derek so he'd say yes to consult on this patient. Derek flashed a smile to his colleague.

Derek suppressed a sigh but however, he liked to consult on interesting cases.

But he had a meningioma resection scheduled later today. He just hoped this would not interfere with his schedule. And a consult on a patient with a Craniopharyngioma[e1] -that'd be way more interesting than a simple aneurysm repair. "You want me to consult in a patient with Craniopharyngioma? Can you give me a brief patient history, please? I would also like to see the most recent scans." Derek was now all in doctor-mode. "This way, Dr. Shepherd." His colleague said as he walked toward the next viewing room.

Derek followed him. His gaze went over to the films instantly.

He was looking at a human brain.

"Patient is seven year old Brianna Davidson." The surgeon started, only to be interrupted by Derek.

"The patient's a kid? This is a pediatric case? Who is the PEDS surgeon on this case?" Derek asked as he stepped nearer to look at the images. "That would be me." Arizona's voice sounded through the room as the blonde pediatric doctor stepped into the room. Derek turned around only to be facing Arizona Robbins.

"Brianna Davidson was admitted under my care so I am the one scrubbing in on this one. When do you want to operate?" She asked, all business now.

"Well, we were discussing tactics." Derek said tentatively, they were figuring out which approach is the best. "Since this tumor's benign, it's elective so we can schedule it for later this week." Derek decided. "Now, I need to know the patient history." He repeated. "Brianna was admitted last week showing symptoms of hydrocephalus due to increase of ICP, bi-temporal hemianopsy and visual changes."

"Let me talk to the parents when we have a concrete treatment plan."

* * *

Meredith met Alex in the hallway. She stopped as she saw him.

"Alex, where are ya heading?" She as she walked next to him. "I need to get my patient to get an MRI." He told her. "Which means I can't accompany you due to my pacer, got it." Meredith laughed for a moment. Having a pacer means she can't do certain things at least not without risks of getting hurt badly. There are restrictions for patient with pacemakers. And she was aware of them all too well. So she can't do anything that involves dealing with MRI.

Okay, she can look on the images _outside_ of the room where the machine is but that's it.

"But you said magnetic resonance tomography. You're on Sloan's service and your patient needs an MRI?" Meredith asked, trying not to sound so surprised but her voice was treacherous and therefore betraying her. Both of them knew it.

"It isn't just all about boobs, Meredith." Alex defended his today's specialty.

"I know, it's all about cleft palates, and reconstructive surgery, I know." Meredith answered with a chuckle. "It's great that you're walking with me to see whether my MRI's finished but what is the reason for it? I mean there has to be a reason. Is there a reason?" Alex Karev suddenly stopped. Meredith avoided looking at him. "C'mon, tell me. I'm not that big of an ass." Alex kept referring to himself as an ass. Meredith made a mental note to tell him that he shouldn't be painting this kind of a picture of himself since for one it wasn't true. "I heard everything. About what Izzie thinks about me, I'm really sorry to bother you with my practically non-existent problems but …" Meredith inhaled deeply before continuing.

"I need to say thanks, Alex, for standing up for me." Meredith looked over to him. "Well, someone has to do it for you, it might as well be me since you all think of me as the asshole." Meredith shook her head, she never had heard him talking about himself so self-degrading. "You're not an asshole, Alex." She assured him. "I don't think so. You're like my overprotective brother. Every man is at some point asshole-ish. But that doesn't mean you are one." Meredith touched his shoulder for a moment. Slowly, Alex nodded. Meredith's words had done exactly what they were supposed to.

Meredith smirked to herself.

"Anyway, thanks for standing up for me. I can't think of any reasons why she would do this. I've never done anything to her besides being friendly. I she really like this because I haven't told her every single thing about _my _private life? Why is she prying into my life? I don't get it. I honestly don't know for how much longer I can take this."

"Maybe you could transfer." Alex suggested, hoping Meredith would decline this.

Inwardly, he cursed himself for mentioning this. Why did he let this slip? For a moment, Meredith was caught off guard. "What no!" Meredith exclaimed loudly. She had never thought about that, not for second. She didn't want to leave Seattle, she was building a life.

"No, I don't want to transfer because of her. I would never transfer just because Izzie doesn't respect me. She isn't the one who really matters to me. What matters, are Derek, Cristina and you, my superiors who all respect me – so I most likely will not transfer to another residency program! I have a life here. They know about me and my medical limitations. They know I can't enter an MRI. They know about it. If I would do that, it wouldn't be very fortunate for my surgical career. Also, I won't let her do this to me anymore. I want to build a life with Derek in Seattle and not at the East Coast or somewhere else. I'm sure they have fine residency spots but I don't need them. I like my life as it is right now." Meredith told him. Alex held up his hands. "Okay, okay. I understand, no need to go all crazy on me, Mer." Alex told her. "I _won't_ transfer to another program or another hospital, just because she thinks she owns this place which she does not do nor will she, fact is I won't transfer that's not even to debate. I have found my footing here, they respect me, okay she does not but those who matter do." Meredith said stubbornly.

"What a shame. I thought you would finally leave." A voice said callously, obviously someone had witnessed their little talk about transfers. Alex and Meredith turned around. "Someone must really hate me." Meredith groaned suppressed as she was face-to-face with who said that. "Izzie." She got out, her teeth gritted. Someone was testing her patience. "Meredith." Her intern colleague repeated her name.

"Why the hell are you listening to private conversations? And it's Dr. Grey to you." Meredith spit out.

"Dr. Grey? Really, Meredith?" She asked mockingly.

"You heard her, Stevens. She wants you to call her Dr. Grey, not Mer, not Meredith. Got it?" Alex interjected and came to the rescue of Meredith. "I'm going to the cafeteria. This is getting sad, actually." Alex said and left, Meredith was coming with him but a page interrupted her. She stopped and looked at the small screen. "Alex, I have to go, thanks for doing this for me." She explained hastily, before storming away over the catwalk.

Meredith avoided the Izzie-problem that was getting bigger by the second. Out of sudden, Meredith's pager beeped. Someone wanted something from her. It was Burke. Her patient in CICU was suffering from ventricular tachycardia again. When Meredith and Cristina came running into the room, the patient was coding. He was in "sustained" V-tach, again. "Why's he coding again?" Meredith silently wondered. "Shouldn't have the amiodarone prevented this from happening?" She whispered over to Cristina. "Maybe he just didn't respond." Cristina answered, her eyes fixed on the monitor. This was bad. If they couldn't get this under control, they were looking at a possible pacer implantation and considering he was previously healthy? Not really what they had in mind. Maybe this has triggered something. The surgery they performed on him might be the cause except he had them prior the accident.

After they had him yet stabilized again, Meredith needed to see Derek. She felt like she hasn't seen him in ages.

"Do we have anything else scheduled or is this a good time to eat something quick and then I'll be good to go?" Meredith rambled nervously. Cristina was there too, she smiled proudly. Meredith's cheeks redden instantly as she heard Dr. Burke. "Go, Grey, you did a good job, you both did."

Burke was oblivious to the fact that Meredith wanted to get away from Izzie who had just entered the room.

To Meredith and Cristina's surprise, Izzie completely ignored them.

For Meredith was it a relief. To be without the snarky comments of her untalented colleague who was most of the time just annoying. But something like that, she would keep to herself.

* * *

Meredith was on her way to the cafeteria. Nurses and other orderlies were walking past her, pushing carts with medical supplies without noticing her. She walked toward the cafeteria hoping she would meet with Derek there. She was lucky because Derek was there and already waiting for her. She looked over the crowd. Suddenly she saw a man with dark curly hair waving over to her. She smiled as she saw him. "Meredith, I'm over here." He called out as he stood up and waved as soon as he saw Meredith standing there, obviously totally clueless.

"Ah, there he is." She murmured to herself. "I'm making myself look like the biggest idiot on earth." Meredith mumbled to herself as she made her way through the tables and let herself fall on a chair where Derek was watching what she does. He was sitting next to her. He glanced at her expectantly. "What?" Meredith asked as she felt his gaze lingering on her.

"How was your day?" He asked, his blue eyes fixating on her.

"My day was hectic between the Code Blue in the morning a few minutes after you left, thanks for that anyway but I could have used your help." Meredith grumbled distinctly.

Derek's face fell.

"Oh, you ran a code without anybody there to help you? Are they frigging irresponsible, not you of course but in general …" Derek shook his head. "I was on my own but I managed."

"I'm proud of you, Mer." He ran his finger over her cheek. "Not here, Derek." Meredith hissed lightly, not wanting anybody to notice what's going on between them.

"You're no fun sometimes." He grimaced. "But you can always make it up tonight." He hinted.

"I'd love to but I have this intern thing scheduled where we learn until we drop for this intern test. Cristina is staying over and so is Alex. I don't know about George and Izzie." She swallowed after mentioning her name.

"Anyway, let's just eat." She was once again avoiding the questions.

She started eating. Derek watched her for some seconds. Meredith knew she was being watched and it was weird but okay. It was just Derek. Derek had heard her tone shifting when she said Izzie's name. It had quavered slightly, anybody else would have missed this shift but he didn't. He knew her that well, well enough to know when something's most certainly not right and right now something was not right. "Is it your roommate again?" He asked softly.

Meredith rammed the fork into her food but she didn't look up.

"Is it true that something is bothering you so much you won't even talk to me?" Derek prodded gently, he was now putting his fork aside and focused on Meredith, not wanting to make her feel uncomfortable.

She just ignored his questions, suddenly denying his existence.

"Mer. Can you please respond in any way?"

Meredith's heart warmed at the soft plea from Derek. But she was indecisive whether to tell him about her Izzie-problem or not. "I just wanted a normal lunch. But nothing, absolute nothing is normal. I mean, look around." Meredith sighed. "Nothing's normal." She gazed over to the other tables, they were all looking over to her and whispered something. And yet she thought the gossiping about her would have stopped. But apparently it has been going on. This is just great, she thought. Her fiancé noticed that she was distracted by something and touched her lightly on her arm to regain her attention.

Meredith flinched in surprise.

Derek chuckled at her reaction.

"You want a normal lunch? Is there even something as a normal lunch?" Derek asked, his eyes were fixed on her and in them she could see sparkles.

"I don't know, honestly, I have no idea."

"There is something else." Derek added. Meredith was now looking at him attentively. "I want you to meet my family." He spluttered out, he waited anxiously for Meredith's reaction. "I am already the slutty intern in Nancy's point of view. They're gonna hate me instantly and then you'll leave … abandonment issues, sorry. I am just freaking out. Meeting the boyfriend's family, I suck at those things. I really do." Meredith rambled. Derek loved her rambling but right now it was important to calm her down before she panics. He knows that she's got quite the history when it comes to family. "This would be my first time. I am a newbie to all this parents-thing. Me, and family just don't work. I mean I am just this girl who wrecked their son's marriage. I am a one-man wrecking ball." Although he'd been over that with her, he was going to tell her again that his mother didn't think of her as someone who ruined her son's marriage.

"Meredith, they will like you." He supplied, hoping she'd believe him.

Meredith scoffed.

"Sure."

"Just shut it, okay? We can do this, just not before the intern exam. I need to concentrate on that, I need to and I need you to understand."

"It is fine, Mer." Derek cupped her cheek with his hand for a second before continuing to eat.

"We'll talk about visiting them in Connecticut after your intern test. After, remember I said _after_."

* * *

Derek was in the OR scrub room. He was waiting for O'Malley. They were operating on a patient with a meningioma and he was late, how can he be late for such a great opportunity. He entered the operating room and looked up to the OR gallery. Only Stevens was sitting there. Apparently, there was nothing to do for her in the pit and now she was watching a procedure. Then, only minutes later, Derek thought with sarcasm, George came running. "Dr. Shepherd, I … apologize for … being late. It's just that …" George stammered, barely able to get in a word edgewise before he was cut off by Derek.

"Get to the point, O'Malley, and quit the rambling." Derek snapped at the intern in irritation.

Why can't people be punctual for one?

That's annoying the crap out of him.

Finally, all of them were ready to start the surgery after O'Malley was there as well.

He kept his head down, not wanting to irritate Derek another time because then he would be more than likely thrown out of the OR and he didn't want that either. "Nice of you to join us, Dr. O'Malley, next time try and keep an eye on the time. Time is important, it can decide whether a patient lives or dies." George nodded.

"On that note, we can start. It's a beautiful day to save lives, let's have some fun."

Then Derek started doing a craniotomy to gain access to the area where the tumor was. Later, he'd be using a technology called IGS where fiducial markers correlate the "real patient" lying on the table to a 3D computer model of the patient based on her MRI and CT scans. They did a CT scan to rule out that the tumor has invaded the bone.

Meredith sat in the gallery, while making notes on the procedure Derek was currently performing. He was resecting a meningioma and since it was a neurosurgical procedure it was particularly interesting for her to watch. So she took notes 'cause she wanted to remember how he did it. As she continued to watch him work, she once again noticed her soon to be husband's brilliance. She knew he was using Image-guided stereotaxy or short IGS to pinpoint the exact location of the tumor. "O'Malley, since it's interesting to stare across the room, I think you might need a difficult question to re-focus on what I am doing. I have my hands in someone's brain right now. So, what are the advantages of using IGS?" Derek asked as he was manhandling the probe. George was taken by surprise.

"Uh, let me think … IGS allows very precise planning of the approach by pinpointing the tumor location and guiding the skin and bone openings." He answered after taking time to answer. Meredith listened to that. Using a hand-held probe, the Derek was tracking the probe's position in real time on the computer model of the patient's anatomy.

So it was easier for him to locate the tumor and remove it without damaging the surrounding tissue.

At some point Derek Shepherd looked up during the surgery. His face lit up when he saw her sitting in the gallery and watching his procedure. He blinked and his eyes twinkled when he looked at her for a short moment. Then he focused back on his work. There was an open brain right in front of him. A few minutes later, someone stepped into the observation gallery and leaned again the wall for a slight moment before sitting down but Meredith never once looked up. The surgery was way more interesting right now, at least for her. This someone cleared his or her throat to gain her attention. Meredith sighed lightly before turning around.

A few hours later, Derek has successfully removed the tumor. He looked up to the gallery and Meredith flashed a smile at Derek. His blue eyes were ever focused on her as he pulled off his scrub cap and advised the nurses what to do next.

Simultaneously, he took of his surgical gown.

He was talking to them about post-op protocol. Then he left the OR and entered the scrub room to wash his hands. Meredith left as well, she was now heading toward the scrub room of operating room 1 where she presumed Derek was right now.

And her intuition wasn't wrong.

He was there. He was standing there, all manly, and scrubbed out. Meredith hovered in the doorway. She once again remembered her mother saying 'People who hover in doorways are coming from nowhere and are heading nowhere.' She shook her head in an attempt to block out Ellis's voice in her head.

Instead, she smiled at Derek and said softly: "Hi, how'd it go?"

"You are really asking, Meredith? I saw you in the gallery throughout the whole thing." He said lightly, to lighten the mood. "I wanted your personal assessment as a surgeon." Meredith only replied.

"Ah, that's where this is headed." Derek laughed in reply. Meredith smacked his arm.

"Hey, don't laugh at me." She pouted.

"I am not laughing at you. You're just so sweet, Mer. I just love you so much." Soon after that, Meredith and Derek were walking down the hallway. "So back to your patient …" Meredith trailed off, letting her fingers run through his hair. "My patient is doing good, I still have to check on him but I pretty much got all of it." Derek smiled.

"The visibility was quite good and the pathology report came back, he was lucky it was only classified WHO I." He added.

"Mer, I am coming home later today, there is still some administrative traffic jam I need to take care off. I'll be off at noon." He kissed her quickly on her lips before heading to his office. Meredith called a quick goodbye before heading to the locker room where she met Cristina who was changing from scrubs into street clothes. "Hey, Cris, are you off as well?" Meredith said as she suppressed a yawn. "Yeah, Burke is doing the surgery tomorrow, so we kind of have to practice." "Well, that's fits into the schedule since we still have to schedule a date for studying and practicing for the intern exam." Meredith rambled helplessly. Cristina held back a smile.

"Really, you wanna schedule a date for studying? When do you want to do it, because I'm in." Cristina stopped in the middle of what she was doing. Meredith looked at her openly.

"It's like today. I mean intern's exam is in two days, when else are we supposed to do it?" Meredith questioned rhetorically. Cristina lifted her arms in defense. "I never said anything against it." She offered, and continued: "I will be there, of course." Out of sudden, George and Alex were walking in. "Hey, Mer's doing a study session at her house this evening, care to join us?" Alex opened his locker, grabbing an apple and started eating it. While chewing he said: "Sure why not?" "George?" Cristina asked. He only nodded. He was Switzerland in this scenario and not on anybody's side. He thought it was for the better and maybe it was.

After George and Alex left the room, Meredith sighed before deciding something: "We should ask Izzie to come too."

Cristina was shocked. This was not what she had in her mind.

"Are you absolutely crazy now? Did your usual craziness go into your brain?" Meredith snorted at Cristina's reaction.

"Come on, I just think it wouldn't be fair to leave her out. That would only give her more reasons to go against me. It would be counterproductive, Cris. Believe me when I say this." Meredith leaned against the lockers and looked down at Cristina who was sitting on the bench looking up to see her face. She doesn't want to add fuel to the fire. Cristina just shook her head in disbelief. She sometimes could not understand Meredith and right now was one of those moments where she just does not get her, what's driven her to make a decision like this. "Where is she by the way?" Meredith wanted to know.

"She's stitching patients up in the pit, Bailey has her on scut for the second day, I believe." Cristina laid down on the bench, stretching herself. Meredith watched her friend amusedly.

"You really want her there after all she did?" Cristina frowned at Meredith's idea. Meredith knew Cristina wasn't pleased with the idea and strongly against it after all what Barbie did to her friend and left her, Derek and Alex to pick up the pieces of her broken friend and fiancé, broken by Izzie. Meredith started to search for words to explain this to Cristina. "Well, this can't go on forever, and someone has to do the first step. It might as well be me." Meredith shrugged as she rummaged in her locker. Cristina stopped in the middle of doing something.

"At least, I can say that I have the decency to try and get over what's happened. That is the difference between her and me." Meredith explained lightly.

"You're serious?" She asked, wanting to make sure Meredith knows what she's doing.

"You really want to do this, letting her come to practice with us for the intern exam? She's the one always undermining your skills as a surgeon and you're helping her?" She asked for another time.

But Meredith wasn't about to change her mind about anything.

"Can you stop doing the thing?" Meredith asked as she pulled out a filled bottle of water. "Stop doing what exactly?" Cristina asked back, her brows furrowed. Meredith normally wasn't like this, so restless and not really looking at her. "Doing the thing where you question my judgment, you can stop, I am not some fragile whatever that has a meltdown every time something's happening and it isn't in my best interests. That doesn't mean I forgive her for what she did to me, it does not." Meredith breathed heavily. Cristina shook her head in utter confusion.

"She told you she would be happy if you'd transfer, Mer." Cristina's tone was now serious.

She wanted her friend to see what that meant. Honestly, she'd no idea why Izzie was still living in Mer's house. If it were her house, she would have thrown her out a long time ago.

She knew her friend had a big heart and was not seeing everything in black and white but this? Izzie had been going against her and she couldn't do anything to help her out of this. And now she was inviting Izzie of all people to study with them. "Who told you that?" Meredith asked harshly. How could she possibly have known? She never even told Derek. Why should she? It's not like she's going to consider it somehow. Meredith slammed her locker shut.

Cristina didn't flinch at the sound.

"Alex. Alex told me."

"I'm going to kill Alex. He was supposed to keep this quiet. Nobody was supposed to know." Meredith grumbled unhappily.

How did her life turn into this freak show?

"Not even me, your person?" Cristina asked. Meredith waited a few seconds before replying to Cristina's question. "I would have told you sometime. Maybe just not now, can we talk about something different than me having a problem with my roommate?" Meredith rolled her eyes. Seriously, why were they all stuck on one topic?

Pondering about Izzie's motives or anything is not how she imagines her time off.

"How's it going with Burke?" Meredith asked. "Does he want you meet his family?" Meredith asked not quite remembering the stripper-incident when Burke recovered from his GSW to the shoulder resulting in nerve damage and tremor. Cristina started laughing, Meredith frowned as she watched Cristina's somewhat weird reaction.

"Remember when Tyler was supposed to guard the door so parents wouldn't walk in on us? Well, one's clear, he's a crappy guard. That's when his parents ran in on us, me naked." Cristina scrunched her face when she remembered Mama Burke visiting her son at Seattle Grace. Papa Burke wasn't nearly as difficult as Mama Burke. "Oh, you were a dirty, dirty stripper. And you know, that kind of wasn't Tyler's fault." Meredith teased, suddenly she remembered everything. It was around the time where she got her appendix out, shortly before that.

"Guess what, now he wants me to meet McFamily, preferable before the wedding."

"Now you're really freaking out, aren't you?" Cristina laughed at Meredith's horrified face expression, taking it in.

Meredith hissed in a stressed out voice: "Shut it, it's so not funny in any way."

Cristina slowly went back to her normal self. "Calm down, Meredith. I am not going to say anything." She said in a weird attempt to stop her friend from freaking out at her.

* * *

**A/N: I hope you liked this. Maybe I'll update before Tuesday. But it's gonna be a way shorter chapter. Please leave reviews.**


	40. Chapter 40

**Chapter 40**

* * *

**We, doctors, take pride in the fact that we can basically sleep standing up. Anytime, anywhere. But it's a false pride, because the truth is after about 20 hours without sleep you might as well just come to work drunk. Doctor or not. So it's no wonder that fatal medical errors increase at night when we doctors are, proudly, sleeping on our feet. Recently, our communal pride has been shattered, and our egos have been wounded by new laws that require that we sleep all day before we work all night. We're not happy about it. But as someone who may one day need medical care, you really should be. Under the cover of darkness people do things they'd never do under the harsh glare of day. Decisions feel wiser. People feel bolder. But when the sun rises, you have to take responsibility for what you did in the dark. And face yourself under the cold, harsh light of day. **Slow Night, So Long; Meredith Grey

* * *

Derek saw Meredith talking to some doctor about some patient. He discreetly waited until she had ended the conversation. When Meredith turned to go he came out of hiding, he called her name. "Meredith, wait for me." Instantaneously she knew something was up. But she didn't expect Derek to come out of nowhere and pull her with him into an on-call room. "I'm sorry but the gossip mill …" Derek stuttered and wiped his hand over his face in a stressed motion. Meredith's eye brows furrowed slightly. Derek was currently acting very un-Derek-y. "What's going on, Derek?" Meredith asked, Derek immediately sensed confusion in her voice. "The nurses were talking about you thinking about transferring to another hospital to finish your residency." Derek decided it was best just to rip off the Band-Aid. Meredith was staring at him, dumbfounded. Her brain cells slowly started registering what he just said. He said something about her wanting to leave Seattle Grace's surgery program. Yes, she'd talked to Alex to it but there was no reason for her to transfer. Izzie didn't count, Meredith knew she was doing this out of professional jealousy and spite. "Since when do you listen to what they say?" Meredith mocked him, trying to win time. But it didn't matter anyway. Her secret was coming out.

"Since it involves my wife, then yes, I listened for once." He answered.

"I care about you." Meredith held onto the bed railing for hold, she was afraid she wouldn't be able to hold herself together once she tells him. "I know." Meredith bowed her head, not wanting to look Derek in the eyes. Derek scowled in disbelief. Meredith was aware that telling him certainly be easy.

"So you did apply for continuing your residency at another hospital?"

Derek's voice quavered. Meredith tempted to reach for his hand and press it slightly. Under normal circumstances, she would have done it but now she wasn't so sure if this was a good idea. Maybe Derek would not want her touching him now that he knows what she is planning to do. But maybe he'll understand. He's McDreamy after all. If anyone understands it is him. It's him.

But she can't do this to him can she?

Can she leave him and Cristina?

She didn't know. She hated what Izzie was doing and what it was doing to her. What it was leading her to do. But she can't tell anyone because then she'd be weak and Meredith Grey wasn't weak.

She was strong.

"Really you want to transfer your residency?" His voice was tremulous and small. That she never intended.

Meredith noticed that change in his voice immediately.

"Yes, I've already applied for several residencies across the country, all the big hotshot facilities. I could transfer my residency to any hospital in the country. I might even consider moving to another state." Meredith said, she didn't mean any of it but Derek didn't notice at all. His face, his shocked expression and the wide eyes were showing her that he thought this was real, that Meredith would be gone in a few weeks, off to another program, with him stuck in Seattle. Derek's breathing accelerated a bit but Mer was unable to notice. "I might really do this." Meredith silently added, wanting to see his reaction. Derek gulped, sucking in a deep breath. He would have to figure out a way to make his wife stay. Derek listened to her with growing shock and fear that his wife would be leaving Seattle. "And when were you going to tell me?" He said wavering and struggled to find words.

Meredith locked eyes with her Derek. "I would have told you at some point."

"Yeah, when it's all said and done." Derek shook his head sadly. His heart was beating hollowly in his chest. Meredith was looking at him. "I just can't do it. Yeah, I can't- Mer always runs, good to see how things doesn't change … right?" She laughed sadly.

"In this moment you are running, Mer. But from what are you running, please tell me. Talk. To me, please. Are you questioning it?" asked Derek, his voice changed abruptly.

He desperately hoped the answer would be no.

Meredith stared at him blankly. Of course she wasn't questioning the marriage. She was questioning something else. There was no place for her at Seattle Grace. The gossip was as bad as always, worse since she'd been released and started to work again. Nurses were gawking on her, some of her fellow colleagues showed no respect for her at all and knowing that hurt. Most of them thought she was a joke, as did Izzie. Meredith couldn't help but feel insignificant. But she couldn't tell Derek. He would go straight to Webber and discuss this with him. But Meredith wanted her options open. Meredith knew she couldn't tolerate Stevens' behavior toward her any longer but there was one thing she needed to do which was showing them that she was better than them.

That she even helped those who most certainly don't deserve any of it. All they saw was her medical condition and everything that comes along with it. But they don't seem to see the surgeon in her.

Meredith knew she could to this.

She was Ellis Grey's daughter after all …

He remembered what he once said to her. "I want to marry you. I want to have kids with you, I want to build us a house. I want to settle down and grow old with you. I want to die when I am 110 years old in your arms." He had known back then that she wasn't ready for this but he promised her he would wait for her to get ready. And he did. Because Meredith had every right to be damaged and he loves her unconditionally. And he wanted her to be okay and if that means waiting. But now, she is ready. They are engaged. They are soon husband and wife. Derek couldn't believe this. But then, Mer wants to transfer or at least, she thinks about it.

And that sends everything crashing down. This is not how he imagined how this would go.

"No, it's not us or our commitment I'm questioning. It's more like why should I be here when there's no respect at all?"

"So this is about Stevens, again?" Derek said, sighing exasperated. "I knew you should've thrown her out." Derek mumbled to himself. "Oh, you knew?" Meredith scoffed lightly, while pursed her lips in disapproval. "Look." Derek threw her an honest look. "I know how she treats you. I don't like it either but at some point you have to face things and you've got to stand up for yourself. I can even talk to the Chief to get this sorted out-" "No, I don't want the Chief involved. I can do this, I'm …"

"… fine? Let me guess, you're fine? Well you don't seem fine. You seem like you want to avoid." Derek wanted her to see what she was doing.

"Well, as you might remember somewhere deep down in your brain is that I avoid." "But it's not just you anymore. There is me in the picture as well, Meredith. I need you to see that." Derek sounded desperate. He loves her, why won't she let him? He didn't know but deep down he was thinking maybe some childhood trauma. She'd never given him the specifics, only hints of her past. She doesn't like talking about it. "I mean, why would you want to move to another state, leave the life you built behind?"

"Because I can't do it anymore, that's why. Nobody seems to care. There is no place for me here. All everyone thinks of me is 'doctor with heart problems'." "So you quit? Have you talked to Bailey about it? Have you tried to find something that could help?"

"I won't whine about this, Derek. I do fine on my very own." Meredith replied.

"Well, if you mean by faxing several applications to other programs without notifying anyone for that matter – yeah, that seems fine to me." Derek replied sarcastically. Meredith noted the undertone. "For you, running seemed to work, time for me to try it as well." "I was walking away from my marriage and met you. I running was one of my best decisions. I don't regret it one bit but what about me, Meredith, when you are on the other side of the country. I don't want to lose you."

Derek tried to tell her that she should talk to Bailey but Meredith didn't seem to think that she was important enough to do it. But she couldn't tell that Derek. He would disapprove of that, of course but … He would tell her that although she was an intern she shouldn't be looked over easily. Meredith was still thinking that about herself.

But Meredith was sure she wasn't worth it. She had done the same thing concerning her relationship with her father. There were enough moments where she wasn't worth it. And this was it. There weren't enough reasons.

She was just an intern as any other intern around her. She is nothing.

"Oh, come on, it's not like I'm enlisting." Meredith shot back as Derek tried to explain. Derek felt silent anger radiating through his veins. Meredith was meaning it. "Yeah, maybe you should. Go join the freaking US Army for I all care. I mean I don't have a say in this, have I? Run off to the freaking desert and keep on avoiding. Great plan, really. This is just what I had in mind." Derek couldn't stop himself in time and before he knew what happened he had said. Of course, he hadn't meant it. When he was angry, he was saying things he didn't mean. And most of it wasn't even true.

Meredith just gazed at him.

"I'm not even sure if I'm a suitable candidate so maybe you don't have to worry about me doing any desert tours anytime soon." Meredith said ironically, her voice was somewhat cool and detached.

"I'm sorry, Mer. I shouldn't have reacted this way. It was wrong."

"It was." She was gazing at him intently.

"But how can I be sure it won't happen again?" Meredith asked quietly. Derek really wanted her to stay here, with him. She knew that now. She heard the emotion in his voice as he said this. "We both said things we shouldn't have and now we're in this mess." Derek reminded her softly.

"Yeah, we're in this mess, messy mess." Meredith chuckled softly.

"Yeah, I guess we have." After a pause Meredith added: "I won't enlist. That never even came into my mind. I swear. I have no, absolutely no intentions of going to a war zone anytime soon you can stop freaking out about it."

Meredith's revelation made breathing for him just a little easier but there was still a chance she would consider a transfer.

And that he didn't like at all.

"Good, so I don't have to worry about you being in the line of fire every day, I just don't want you to end up with a bullet to your abdomen or something and the likelihood that that's gonna be the case is much higher when you're facing mortar fire every day." "Derek." Meredith interrupted him. "You're rambling. It's cute but you're missing the point." Meredith mused, a contagious giggle escaped her and Derek smiled as well. "I think you are right." Derek slowly said, not knowing how he was missing the point.

"Come on, we can do this. If anyone can do this, it's us." She said in a strong voice.

"I just don't like the thought of you being in another state." Derek protested. "But if that's what you want, I won't hold you back. Where'd you apply to?" Derek wanted to know, softly his hands grabbed Meredith's to stop her from fidgeting on her shirt, nervously. Derek's ice blue eyes were fixated on her.

"Where'd you apply to?" Meredith looked to ground. She cleared her throat before answering or attempting to answer Derek's question. "For one, there's Mount Sinai …" Derek interrupted her confused.

"You applied to the place where I worked before, seriously?" He asked with widened eyes.

This was getting more and more shocking by the very minute. Derek couldn't believe it. Why was she suddenly so set on leaving Seattle?

Why in god's name would she do that?

When she doesn't answer, Derek nudged her softly.

"Mer?" He asked worrisome.

"I'm fine, Derek." He got as an answer.

"As for your question, I seriously replied for Mount Sinai and some other high-profile hospitals all over the country. They all want me. I could start as soon as the intern test is through." Meredith shrugged off his concerns.

Derek stared at her in denial. She had applied to hospitals like Eastern Virginia Medical School, Cedars-Sinai in LA, Mount Sinai, Columbia University Medical Center, Johns Hopkins, Harvard or more Massachusetts General Hospital, Stanford, Dartmouth, UCLA, Cleveland Clinic, San Francisco Memorial on the faxes she'd sent to those programs. Meredith knew the other would wonder how Meredith got the heads of those programs to secure her a spot. Well, she was royally inbred.

All she wanted were options. So she could decide what was best for her. If she started on any other hospital, she'd tell them from the beginning. She would tell them in the beginning before something bad could happen and there was no Derek and Cristina to babysit her.

This was a lesson learned, more like painfully learned.

She wouldn't do it again. It wouldn't do her any good. It hadn't done her anything good. Well, they would have needed to know anyway. About why she can't go into a MRI screening room … If she did do that it would end with her badly injured, at best. But Meredith was rambling again, and she probably should just stop it. It would be fine.

But Derek didn't seem to see it the same way and he was looking at her big-eyed and wanting answer, answers she couldn't give him.

She saw the hurt and the questions lingering in his eyes but she couldn't make sense of them.

This would be fine.

She was going to pass the test and then she would see what is.

If Meredith would really transfer her residency to another hospital – she was not really sure about it anyway. So there was nothing to _concrete_.

Hell, she wasn't even sure about it.

And hopefully she would have a clearer view of what to after the intern exam.

Cristina would probably *kill* her when she knows about her plans.

She doesn't know about it, at least not really.

"What about us, Mer, what about us? We're getting married. I have a job here. I built a life here with you. I don't really want to leave Seattle." Derek said.

Meredith glanced at him for a moment, then she said: "I know what we have here is precious, we probably won't find anything elsewhere but have you seen how …" "… how Stevens treats you? I might have yelled at George for it." He supplied silently. Meredith choked back a laugher. "You yelled at O'Malley? Why did you yell at him?" She asked. "Because he just stands there and watches you and Stevens." Derek replied angrily. Meredith giggled lightly. This is why she loved Derek.

"So you thought it would be a good idea to go and do something stupid?" "You called me stupid?" Meredith nodded.

"Sometimes you are. But I love you anyways." She smiled sweetly, a smile he just couldn't resist. A smile he fell in love with. He pulled her nearer and kissed her gently before loosening his grip on her. "So do you. That's why we will figure this out." Meredith smiled at him, a little. For the next few minutes, they both sat there in total quiet, Derek was embracing Mer and gently rocking her back and forth like a child. They would be okay either way, simply enjoying the simplicity of the moment where it was just them and no one else disturbing them.

They needed that moment.

**9:17 PM**

Meredith was walking down the hallway. She rubbed her eyes tiredly. She'd been here for what forty-eight hours straight and it was now showing. She was looking toward sleeping in her own bed, preferably without disturbances. Suddenly she ran into nurse Debbie who was happily chatting with another nurse about some topic, occupying the seats at the nurses' station. Meredith knew she still had to finish up on some charting before being able to go home. Meredith sat down on one chair and started scribbling down her report. By the time she was almost finished, a nurse called her to a post-op patient who needed a doctor to give him an exam. "Dr. Grey. We need you here." Meredith dropped everything she did and sprinted over to the patient's room.

"What do we have?" She got out, reaching instinctively for the chart and looking through it.

"Mr. Jones suddenly spiked a post-op fever. His family is extremely worried and in the waiting room, they are hoping that you could give them an update when you're finished here." Well, they should be. Post-op fever never indicates anything good. She knows that from experience. "That doesn't sound so good." Meredith muttered under her breath.

This was patient of Dr. Bailey's- and with that hers.

So she definitely needed to keep an eye on him. When she looked at the patient, she was immediately worried, he was pale and sweaty and he was shivering. "We need to run repeat labs to find out why this is happening." Meredith ordered after doing a quick but thorough examination.

When Meredith had dealt with the situation, she'd prescribed some meds that should help, she walked in on Izzie and some other resident or intern, at least that's what she guessed.

She wasn't sure, though.

They were both happily talking about someone.

Scratch that, they were gossiping about her.

"She thinks she's the best only because she got a few answers right. And then 'I want it to be fair'. Nothing 'bout this is being fair." Izzie grumbled. The second year resident of whom she'd never heard off nor does she know her name, saw her presence and catched Meredith staring at them. Meredith only heard her name and knew that they were talking about her. "Hey you, Dr. 'I am better than anybody else'-Grey!" The resident she doesn't know called her name and made a snazzy remark on top of that. Meredith just ignored that remark. Out of habit, Meredith responded without complaining. She walked up to Izzie and her newfound friend, apparently and friendly asked what she should do. "I want you to get the overnight labs and then there is some pile on the nurses' station you might want to think about doing. And someone needs to cover the pit." The voice sounded stiff and harsh. It was the total opposite.

"Well, if you say it that way it seems like I am gonna be the one who's actually doing it." Meredith countered ironically. Of course she was the one doing this. How else would it be? "You've got a keen mind." The resident only replied.

Meredith shook her head.

Right now she would gladly be on Derek's service.

At least he'd treat like a human being, an actual human being. Meredith turned and asked: "Might I ask you about your name; Dr. …?" She shot at glance at her opposite. Izzie rolled her eyes at Meredith's persistence. "It's Dr. Myers to you." She said harshly, dismissing Meredith what caused Izzie to giggle. Meredith thought to herself, do I even want to know what this is about? No she doesn't want to know. So she just went to get the overnight and priority labs ready for her resident. She was doing her job and she was doing it right. Although, if Derek knew she was still working, he'd be really angry with her.

He was scared that she would work herself into the ground.

On her way to the lab where the labs where waiting for her, she passed the ortho resident.

"Dr. Grey? You're still here?" Callie Torres asked. She had seen the young intern hours ago, scrubbing in on an emergency cardio patient.

But that was last night, or more the night before.

She made a mental note to mention it to Bailey. "Yeah, I've got to get those lab reports and then there is some charting that needs to be done. I'll go home when I've finished that." Meredith promised. Callie furrowed her brows, seeing the exhausted features of Meredith. "Sure." Meredith kept on walking and finally she reached her destination, the lab tech was already waiting for her.

"Hey, Grey. It's been some time since I last saw you." He flashed a friendly smile as he waited for her reply. Meredith smiled slightly embarrassed.

"I know, there's been a lot going on lately." Meredith explained, not mentioning her having to have surgery with any word. He does not need to know. It was like Burke said to her. "Here are the requested labs." "Thanks. Anyways, I need to go." Meredith pointed with her hand in the opposite direction. When she got back to the nurses' station paperwork waited for her, tons of charts that need to be completed with ECG, x-rays, CTs or MRIs. And she was doing blood work.

This was going to be one long night, Meredith thought to herself, as she was suppressing a yawn.

Derek was off this night. He had two days off in a row so he thought it would a good idea to go out with Mark to Joe's Bar. He needed some, how Mer would call it, it pained him to think like that, freak out time with Mark. "Mark, have you time to go to Joe's?" Derek asked, his friend was sensing by the intonation of his voice that it was urgent.

"Sure, what's up?" Mark questioned.

"Meredith and I, we're facing something and I need to get away for some time and you have to help."

"You're not fleeing the country again as you did …" Before Mark could end it, someone appeared behind them. "… as you did with me, Derek." Derek turned around, shocked that his former wife had been listening to his conversations with Mark. "Don't you dare do that with Meredith, she does not deserve that." "Why are you acting so advocating towards Mer?" Derek asked, now he was mostly confused. "I mean …" "I know what you mean. You think I hate or despise her for stealing my husband. I don't. Over the months I've gotten to know Meredith and she's easy to like." Addison stated bluntly, Derek and Mark stared at her flabbergasted. "You're already facing problems? You aren't even married yet. That was fast." Mark couldn't resist. His friend's face was cold and he knew instantly this was a mistake. He shouldn't have said that.

"You're getting married?" Addison couldn't cover up the surprise that was covering her face. She turned to Derek. "Why didn't you say anything?" She asked him enthusiastically. Derek's eyebrow arched. How could it be that his ex-wife was okay with it that that he got re-married so fast … "Meredith didn't want to tell anyone, she wanted to wait until the gossip dies down."

"I have known." Mark proudly said.

"Cristina did too." He added, grinning stupefied.

"Congratulations." Addie congratulated him softly. She knew that this would happen at some point. Then she abruptly left Joe's Bar. Apparently, this wasn't so okay for her. "She wants to transfer, Mark." Derek said as he was sitting over his glass of Scotch. Mark was there too. After his surgery he did with Alex, Mark had been kidnapped by Derek who dragged him to Joe's Bar for discussing another crisis in the Shepherd/Grey household. Meredith was at home with her friends, learning for the intern exam.

At least he thought she was.

When she really wasn't- she was at the hospital, working another shift. Had he known this he would have stopped her from doing this to herself.

"She wants what?" Meredith keeps surprising him more and more. First the whole CHD-thing and then a whole other bomb was dropped on him.

"Want a refill?" Joe asked Derek as he emptied his glass.

"Go for it." He just said, confused by Meredith's sudden need to go away from here.

And yet he always thought she liked Seattle.

And the ferryboats, she likes them (and he knows she likes his ferryboat scrub cap as well, he'd noticed that …) and what about Cristina?

And what about their land?

Derek felt like all his plans suddenly dissolve into nothing. That's how he is feeling. Mark had no idea what to say to his friend.

What does someone say in such a situation? He had no idea.

"So, Grey's really …" He started a sentence only to be cut off by Derek. "Yeah, I already told you that, Mark." Derek scowled at his friend who looked away. "Okay, fine. I am just gonna shut up." Mark smirked and went back to drinking his beer. "I'd appreciate that." "So you can go be sulky without anyone annoying you." Mark couldn't help himself but say it. Derek sent him a death glare. Mark held up his arms.

"Okay, okay. I'll be silent, for real now." "Grr, Mark, you better look out." Derek grumbled inwardly.

His friend suppressed a chuckle rising up in his throat.

**10:37 AM**

In that moment, she was paged to the pit. After she handled the three admissions, treated them, one of them would be scheduled for surgery today. "What do we have?" "John Doe, crashed his motorcycle against a tree." Meredith nodded as she got the normal information about the state of her patient like blood pressure and other vital information. "Trauma room 2." She directed as the paramedics pushed the gurney to Trauma 2. When she got view of his leg she immediately paged ortho and started with doing a thorough exam including palpating his abdomen to check his internal organs, checking for any signs of head injury. She also looked for other broken bones, checking for further injuries. The man was unconscious and because of the leg he'd lost a certain amount of blood so she continued with shock protocol. She'd paged ortho down for a consult and after some time, Callie did answer her pager.

"Grey, wasn't Stevens supposed to be managing the pit?" She asked.

"Well apparently, I am the one covering it." Meredith stammered, pressing a hand against her head to stop the world from moving.

Callie noticed that.

"Grey, take a break. This is an order. I manage this patient. I do the trauma films myself. If he needs surgery, I will page you to scrub in with me." She responded, scanning Grey shortly. "That sounds good to me." Meredith agreed with Callie as she left the pit. It turns out the patient needs surgery. Callie Torres saw that at first glance. She was doing the x-rays herself. Meanwhile, Meredith went to get something to eat from the vending machine near the nurses' station. She also went to the locker room to splash some water on her face so she would wake up fully.

It was important that she ate, her system needed the vitamins and energy to get through this shift. Her half-glass full coffee was still standing next to her charts. It was cold.

"Ew, it's cold." Meredith mumbled as she disposed it into the trash can. When she was finished with refreshing and eating she answered her page. Callie Torres had paged her to the OR. So Callie immediately alerted the OR to let them know that they were coming so that they could prepare, paged Meredith and soon the both of them were scrubbing in. The patient was already under general anesthesia as Meredith Grey entered the OR, and ready and prepped. Callie smiled at the young doctor warmly as she took the place near the OR table. Her job was it to suction.

His tibia was shattered in two places, the bone was sticking out of his skin. Meredith assisted Callie as she was placing the rod and the screws. It was such a freak injury as Callie said.

They were in the operating room for seven hours straight.

Callie let Meredith do some parts of the procedure, she had how hard the young intern worked. She had a talent even if she wasn't interested in orthopedic surgery. It's been long since she had an intern or a resident with interest in ortho. Once the patient's sats were plummeting for a moment but they quickly got him stabilized again.

Meredith was more than tired afterwards but being in the OR was way more interesting than running labs and doing blood work on post-op patients, monitoring their progress overnight. Bur that was the job and so it comes, that Meredith does not once complain. Some needed more pain meds, one needed some additional IV antibiotics due to post-op infection.

Meredith was positive that the antibiotics would work and so she continued with the charting.

She barely made any breaks. She just pushed through.

**5:09 AM**

The orthopedic surgeon looked at Meredith as they both scrubbed out. Normally, Callie would have told the intern to manage the post-op care but in Grey's case she was doing an exception. From the looks it seemed like Meredith was on the verge of collapsing. Callie was searching for Dr. Bailey. She wasn't sure if Bailey was cool with Meredith working such long hours. She'd been working overtime. All the other interns went home at some point except Grey. She'd been working for the last three or four days practically nonstop. Little did she know that Mer slept whenever she had the time but clearly this girl's exhausted and overtired from all the working ...

Callie knew at some point, it would be enough-even though interns were nobodies, and at the bottom of the surgical food chain, this wasn't what it meant. They were not trying to kill interns with overtime.

They weren't invisible or insignificant.

So she was going to inform Bailey about it and let her handle it. It was her intern after all. By the time she found Bailey, it was already 5 AM. "Dr. Bailey, Dr. Bailey, wait." She called out, as she ran the last meters to keep up with her colleague. "There is something …" She said out of breath.

"Something I need to talk about to you." She said.

"Spit it out, Torres. I have Stevens and O'Malley working today and I need to supervise them. Stevens is supposed to cover the pit, O'Malley is on scut." Callie frowned as she heard what Bailey was saying. "I just wanted to inform you about what's going on - Stevens is definitely not covering the pit. Grey is. She seems to be multi-tasking between the pit and the boatloads of paperwork." Bailey looked up in shock.

"Are you sure?" She asked in her usual manner.

"What, am I sure? Of course I am sure. She just scrubbed in on my patient after treating him in the pit. Now she is back to charting."

"Damn foolish girl, she's put in way too many hours recently - stupid, stupid, stupid girl. Why did not she say no to the extra hours? As far as I know, Yang went home hours ago. Only Meredith didn't." Bailey ranted as she realized the extent of the situation.

"So if Grey's doing all the grunt work, where are my suck-ups?"

She reached for her pager and instantly paging Stevens and O'Malley. "Thank you for informing me of this. This is inacceptable." Bailey shook her head as both residents waited for the interns to show up.

"I can have them cover my post-op patient's care." Callie offered.

"They'd be stuck dealing with him till morning. In addition, I have some charting to do which I can delegate over to them, leaving them stuck dealing with it." Bailey thought this offer before gladly accepting the help of her fellow surgeon. "Well, we residents gotta stick together, don't we?" Callie asked, half in fun. Soon, both of them came, slowly and fully relaxed, obviously. Callie shared a view with Bailey. Bailey's blood boiled but she pulled herself together.

"Stevens, O'Malley."

Her voice was icy.

They both froze at the tone of her.

"Since you seemed to think it would a clever idea to avoid your primary orders from your resident, I'm forced to enforce this harder. You two are maintaining the post-op care of Callie's post-op motorcycle guy and you will inform me of every medical decision you make because I don't trust you anymore. You were supposed to cover the pit and instead Grey is covering it, Grey who is already over the eighty hour limit. So, shame on both of you."

Callie cut in: "You will also do all my charting and I want it finished by the time I get back to you which is in exactly two hours. I'll be catching up on sleep, if you need me page me, preferably before the patient is actually dying."

Izzie and George started protesting almost immediately.

Callie's mood was almost as bad as Bailey's and the interns got to know that. "But Bailey, Meredith offered to do this." Izzie defended herself. Bailey knew it was a lie. That girl was too damn proud to admit that she was in the need to sleep. It was more like the other interns tricked her into covering their work. Bailey scowled at the prospect of them whining about something they should have done from the beginning. "Stop whining and do what you're supposed to be doing. Otherwise I am going to get very angry and you don't want to be here for that. Believe when I say that. However what happened here tonight, it won't be tolerated and I will be forced to inform the Chief about what happened because this is inacceptable."

"You wouldn't do that." Izzie said, laughing nervously, earning a smack in the side from George O'Malley who didn't want to make the situation worse than it already is.

The tension was almost palpable.

"Humor me."

Dr. Bailey chuckled ironically although this wasn't a real laugh. Izzie and George shrunk noticeably at the harsh comment.

"You wouldn't."

Izzie was sure of her herself, positive that Bailey wouldn't rat them out to the Chief-

Bu apparently she was wrong.

"Would I? Damned fools, too proud to the work they're supposed to do." She muttered under her breath. "I wouldn't be so sure if I were you." Bailey growled at them. They looked at her, scared. Maybe they shouldn't have done this to Meredith.

At the mention of the Bailey going to Chief to make him call in a meeting was too much.

Their scared faces were enough of a satisfaction for Dr. Bailey.

Callie watched them standing there like idiots.

"Go, it's a little hard to monitor your patient when your patient is in the recovery wing of this hospital."

At Callie's harsh remark, Stevens and O'Malley walked off. "This is all, your fault." They heard O'Malley say, accusing. Izzie scowled. "Really, you are blaming me for everything that has gone wrong?" Accusations have been throwing back and forth between them.

**5:15**

She never heard Derek coming behind her and jerking her around to face him. "What are you still doing here, Mer? You've been her nonstop since your night on call." He glanced at her questioningly as he leaned against the counter, clad in dark blue scrubs and he was wearing a white coat as well, she saw his insignia on it Dr. Derek Shepherd M.D., F.A.C.S., gorgeous blue eyes were focused on Mer as he looked at her and her fatigued and exhausted figure. She could tell he was worried. "You're supposed to home, resting. You already covered a night shift, there's no need for doing it for another night when one of the other interns could have done it." "I don't want to be favored, I just want to be treated as any intern around here and that involves night shifts." Meredith shrugged and took a sip of her coffee as she continued to update charts. Meredith looked at him before asking. "What are you doing here, Derek? As far as I know are you off today."

"Yeah but a certain resident called me to make sure my *wife* doesn't kill herself with paperwork." "Bailey called you?" Meredith exclaimed horrified.

"You told her, Mer?"

"Not now, Derek. I need to finish this up before rounds." Derek smiled at her softly. Meredith so damn stubborn but he also saw she was tired, very tired. He knew she was off then. Bailey had changed her work schedule. Her next shift was tomorrow, day shift. Not night. Derek was relieved about that since the intern exam was soon.

And there she needed to be on top of her game.

**5:35 AM**

"What was that about?" Alex questioned as he saw Derek walking past him, without even glancing at him or nodding to acknowledge him.

"Are you having one of your stupid fights?" He asked.

Meredith couldn't tell him about what it was. That it was about Meredith wanting to transfer her residency to another hospital just to avoid Izzie, so that she doesn't have to meet her anymore. Because that sounds extremely extreme – it does.

Meredith frowned as he was being nosy.

"Uh, nothing." She replied, keeping a straight face.

Alex didn't need to know that she had blatantly changed her mind about transferring to another hospital.

"You sure it's nothing. You've got something that's telling me that that is not true. What is it, Mer? Out with it." He glanced at her expectantly. He'd been running labs for the last hours. The only good thing was that Sloan let him scrub in on his Rhinoplasty.

"I might have rethought my decision about the whole transfer-y thing."

"Whoa, that would explain Derek's behavior. I am guessing he's not so happy about this?" Alex asked tentatively, hoping he wasn't being an insensible ass. "Of course he is not. But I don't see any other options lying around are there?" She asked metaphorically speaking.

"It does not seem like it, at least not at the first glance." Alex shrugged.

"I hope you know what you do. I am not trying to talk you out of it because it is really not my concern but I sure hope you do what's best for you." Alex tried to be supportive. Meredith appreciated that. "But I will sure kick Izzie's ass, metaphorically speaking. It wouldn't be fair to her so no fist fight between me and her." Alec muttered under his breath. "I will kick her ass if you go because of her." "Well, for now it's all open for me, apparently." Meredith tried to tell him. "Yeah, but for how long before you will decide to leave for Hopkins or whatever program you chose." Alex commented. "Well, I am not deciding right now. I don't even know if I accept one the other spots, I mean I have a lot of options."

"Ugh, don't remind, Ellis Grey's daughter." Alex grumbled.

Meredith laughed. Because that would mean moving and now with Derek and I being engaged and all …" Meredith turned her head away. She didn't even notice she said something she shouldn't have said or mentioned at all because now there is a possibility that Derek might really kill her. She was supposed to say anything about the impending wedding and that she was Derek's soon to be wife.

"You're what, Mer? What did you just say?" Alex gaped at her with an open mouth.

"You and Shepherd are getting married?" He exclaimed, a touch of disbelief was in his voice. Meredith's eyes lit up. She was looking forward to it. But they haven't started planning it. It will a small ceremony, nothing big, bride-y thing. "Yeah, we're getting married." Meredith replied, grateful that finally someone outside of Cristina and Mark about her engagement to Derek knew. And Alex for sure wouldn't say anything.

"Congrats, man." He patted her on the back, a silent agreement that he was okay with her marrying Derek. "You deserve this."

"You do too, Alex." Meredith replied.

"Nah, there is too much baggage." "Not a good reason, remember, Alex, my childhood wasn't the best there is, my father was practically non-existent, my mother was always working at the hospital, then the hospital visits due to my condition. Well, I practically lived there. So, no reason for not being happy, don't let a crappy childhood get in the way of your happiness." Meredith advised. "Well, there are no women for me in the mix." Alex shrugged it off. "I leave the marriage thing to you and Derek. You both seem to want it." Out of sudden, they both heard footsteps coming along the way.

"I guess I have an old bone to pick with you, Grey or should I say future-Shepherd." Bailey's voice sounded through the deserted hallway. Luckily they were halfway alone without any nurses hovering around.

Meredith turned around, only thinking: Crap, crap, crap. I am officially … crap. What do I do now? But she already knew, probably because of Derek. All those thought spun through her head and were making her dizzy. And the overwhelming tiredness on top of that was more than she could bear. Bailey was standing there, hands on her hips. "What was that about marriage, you and Shepherd are …" Crap, Meredith's officially dead. She thinks when she sees Bailey asking her about her and Derek's impending wedding … "Grey. Would mind answer me?" Bailey's voice had yet a sound of determination. "Yes, Dr. Bailey. You've heard correctly. Derek and I are getting married, after the intern exam and after I met his family. I think he's giving me an out. I mean he has four sisters. Four. Can you imagine having four sisters? I can barely cope with having two half-sisters I never knew about until now." Meredith rambled. "Grey, you don't have to say everything that is on your mind. But congratulations, Grey." The general surgeon said, a sincere smile was covering her features. "Okay, I am … I still have some charts to update." Meredith excused herself hastily. Alex looked at her retreating back. "I'm going home." He mumbled to himself. "My shift has ended a long time ago." Bailey was on her way to OR 1 where the Chief has requested her to help with a case.

Meredith sat at the nurses' station and was charting.

Izzie had dumped all her paperwork on Meredith and now she sat there, scribbling physicians' notes into her patients' charts. She did additional ECGs, ran labs if they needed to be run. At some point, Cristina sat down on the chair next to her, putting her feet on her table and watched Mer. "Whatcha doing, Mer?" She asked as she handed her a mocha latte, figuring Meredith would need it.

"I thought you went home? Are you doing another sixteen hour shift? This is the fourth shift you're doing? Are you crazy?"

Cristina was here early hence wanting in on some interesting surgeries. But she had gone home and catched a good night's sleep while Meredith had been here- Cristina could scream at the unfairness of this but she didn't.

Bailey would send her home.

When she sees the state Grey's in, there is no way she will let Meredith report for another shift. "I am just doing paperwork that isn't mine, not that I am complaining because I am not. Half of those patients aren't even mine. I mean, whose patient is Mrs. Sanchez in 2672, the one with the gastric bypass?"

Meredith took a sip from her coffee, her pen rushing over paper. Her thoughts went back to Derek. He really was thinking she was going to move to another city anytime soon. Meredith honestly had no idea what she wanted. Yes, she'd said to Alex, she'd stay in Seattle but with all that is going on … maybe it's good to change things. And right now, she needed to change things. But in order make these changes she needed to have slept properly. Right now, she was so tired. A day shift, then followed by a night shift and another day shift and another night shift was too much. It was quite early and she was looking forward to go home and sleep. She knew with every pore of her being that she needed sleep.

"Meredith?" Cristina's voice sunk into her conscience.

"Meredith? Are you even listening? You've been spacing out for like, five minutes."

Meredith knew Cristina was exaggerating. "I was at home while you were here." Then she added, bluntly, "You should go home. You look like death. You should go home otherwise you're gonna pass out on your own accord, Mer. I mean it. Take a break. Eat. Sleep for god's sake." Cristina advised before standing up and going toward the locker room, leaving Meredith all by herself. As Cristina walked away, Meredith laid down her pencil and swiped her hands about her face tiredly. She could sleep right here, only then Bailey would kill her. By the time, the other interns and Dr. Bailey started rounding and coming toward the nurses' station, Meredith had finished her work as she is supposed to. She'd been running labs, attending to patients in pre-op and post-op.

She dumped her stack of paperwork on the countertop for Bailey and sorted it into appropriate piles.

Hoping that Bailey would appreciate what she's done and that she sees that she is hard-working and stuff.

She felt nurse Debbie's eyes on her.

But Meredith just smiled politely and murmured a good morning. She'd never said a harsh word against the nursing staff no matter how hard the gossip was. But after tonight, Debbie reconsidered her attitude toward Meredith Grey. Sure, they'd been hard on her because of her name. But she was good, eventually she would have to say this. Grey was one of the good ones. She was polite, more considerate and soft-spoken. And she showed respect toward the nursing staff.

Bailey entered the locker room and made herself noticeable when clearing her throat. Instantly, Izzie and her intern colleagues were turning their attention to Dr. Bailey. "Since some of you seemed to think I would notice you slacking you were wrong. So I have ask you and I mean you two specifically where were you last night? Stevens, O'Malley, this is concerning you and the fact that made to think it would be okay to let Dr. Grey do all the hard work when she was supposed to have the night off. Now, anyone of you suck-ups care to explain how it happened?" Dr. Bailey's face and tone clearly indicated that she wasn't in a good mood. She eyed Izzie and George expectantly, grimly. 7

"This is inacceptable. I can't have one intern working her ass off and the others are slacking, playing 'Go Fish' in the tunnels." Bailey threw an angered look at Stevens and O'Malley who seemed to get smaller by the minute. Alex leaned against the locker, arms crossed over his chest and waited for them to answer.

They did nothing wrong.

Okay, Cristina could have helped Meredith but this girl's so damn stubborn that she won't accept help.

Cristina wasn't there, she was with Meredith at the nurses' station, waiting for them to turn up. "Now, follow me. I don't want anyone to cross me today. I am in a very bad mood and that's partially due to what happened tonight here. To let one thing be clear, this will have consequences." Dr. Bailey and the rest of her intern group approached the nurses' station. Meredith was there as was Cristina. Cristina had a half-mocking smile on her face. She knew Izzie was hoping she'd be late. Meredith got up from the chair she'd been sitting on for the last hours.

She wasn't sure if her legs would be able to support her weight due to the lack of sleep and food. Bailey immediately saw exhaustion, deep exhaustion gracing her hard-working intern's features. "I have here the overnight and priority labs, the blood work and the charts – all sorted for you. I've rounded on your patients. Ms. Halloran had increased pain this night so I increased his pain meds." She started, giving her facts to her patients.

Bailey glanced at her, knowing by the dull and lifeless look in her eyes that she must be exhausted. Really exhausted, on the verge of going to sleep right there on the countertop.

"Mr. Keller spiked a post-op fever last night so I added some IV antibiotics, it's all noted in his fully dictated chart." Meredith finished, staying still so she would be conserving her energy.

Dr. Bailey nodded impressed.

"Also, we have three admissions." Meredith exhaled, for a moment black spots danced before her eyes and she swayed for a second which luckily no one noticed.

"One had surgery last night, successfully performed by Dr. Torres and me. The others were stable after receiving treatment. I am fairly sure that Mr. Ubarra can be released since he was just here for overnight observation. Mrs. Heller on the other hand might need to be placed in the surgical schedule for today due to internal bleeding which I continuously monitored. She was stable overnight but repeat scans showed that the bleeders didn't resolve on its own so it's yours to determine whether to operate or not." Meredith reeled off.

Meredith Grey breathed in.

She was noticing Bailey's pleased and obviously impressed face expression.

At least she'd done something right, she happily registered. What a relief for her. She walked over to the counter and looked through Meredith's work herself. After a while she said with her soft smile, "Good job, Dr. Grey."

Meredith returned the smile lightly.

The others only then saw how bad she looked.

"She was just on scut." Izzie grumbled. She was moody as hell. She and George were being punished with monitoring Callie's patient. "Scut you were supposed to be doing."

"Karev, you're on Sloan's service." Bailey started with the assignments, "Yang, you're on Arizona's service."

Pediatrics, again?

Cristina thought to herself. Meredith laughed when she saw Cristina's face. "If you're lucky you get a cardio patient, Cris." She whispered. "Grey, you're done here. Go home. I will see you ..."

"Thank you Dr. Bailey." Meredith smiled relieved at the prospect of getting some sleep.

"You won't tomorrow, rounds are at 4." She added.

* * *

Meredith was so relieved when she was finally home. She had no idea how she made it home, how she made it home without an accident. That was a miracle by itself. Bed. A bed is all she wanted. And maybe food. Some cold pizza would have to do it. She didn't have the energy to order something. Her energy resources were used.

She could fall asleep right on the kitchen table.

It seems like Derek had noticed someone came home. He walked down the stairs and was shocked to see Meredith in that state. He instantly saw how bad she looked.

She was pale and tired, lacked energy.

"Meredith, you're home." He exclaimed, coming over to her.

She'd clearly overdone it, he saw it. Meredith looked into the handsome face of her soon to be husband who gasped as he got view of her exhausted features. "I'm fine." She mumbled, barely coherent. The purplish circles around her eyes, the bloodless lips – he was all painfully aware of that. "Just bed." Meredith mumbled, barely able to get onto her feet. "What about food, Meredith?" Derek asked worriedly. "I will eat tomorrow. Now I just want to curl up and sleep. Sleep is all I want." Meredith tiredly said, pushing her up. "Wait, I'll carry you up. You're too tired." Gently, he lifted her up and carried her upstairs where he laid her down onto her bed. "I love you, Der." Meredith mumbled moments before she fell asleep. "I love you too." He said to the sleeping figure. He told himself he would prepare a good breakfast for Mer when she wakes up. Like scrambled eggs or something like that. Meredith slept for twelve hours straight. She never even stirred, Derek just sat there listening to her breathe and snore. He chuckled at her snoring, he wondered once again who such a tiny person could make so much noise. By the time she woke up he'd prepared a fresh breakfast, a healthy breakfast consisting of fruits, whole grain bread and orange juice to regain energy, supported by previous sleep. He wanted to surprise Meredith.

Meredith was a very loyal person. At the end of the day she was waiting for Izzie to tell her about the interns' learning days before the big test so they could study. It wasn't fair to exclude Izzie when she knows she probably going to fail if there is no miracle happening. But right now she was waiting for someone to show up but apparently, this someone was too busy making new friends with some resident Meredith never knew about. "Why are you offering this?" Izzie asked, positively surprised. She hadn't expected Meredith to be so loyal after all she's done to her. "If I were you …"

"But you are not, luckily for you." Meredith interjected with an eye roll. "If I was you, I wouldn't have looked at myself ever again, not even to mention this. This is generous, really." Meredith ignored the ironic undertone in Izzie's voice, telling herself once again she can do this. Be the better guy or more, girl – or whatever. Meredith gawked at her for a moment before saying: "Well, you still have a lot to learn. Izzie, if you want to pass it you need to this." Meredith said nothing but the truth. Izzie scowled. "I sure do but so do you." Meredith didn't reply really.

"Fine, I will come." Izzie finally agreed.

But there was no word on what happened the day before that, Meredith registered.

* * *

At the end of the day, Meredith went home together with her intern group.

There was everybody besides George who was learning with Callie who was still angry with him but … He had no idea that she would dump him soonish. Because this wasn't the guy she once fell in love with.

Izzie was there too. Meredith was quite loyal in that point of concern. She was. After Izzie asked she said yes because Izzie clearly had a lot to learn. She asked herself how she was going to do this. She still had a lot of deficits in almost every specialty. In three days was intern exam.

Meredith was already driving Derek crazy with all the craziness and all. She was practically learning whenever she can although she didn't need to. She knew her stuff. He was pretty sure that she and Yang would have passed the test even if it was two weeks ago.

But now, in all the craziness' name, the interns who looked very sleep-deprived and not in their best mood, were occupying Meredith's kitchen with medical books, Callie's flashcards and timer. "How do you treat _pancreatic divisum_?" Cristina asked. "Izzie." She said the blonde doctor's name. Izzie just held up her empty mug. She was visibly tired 'cause Cristina doesn't let them sleep since today's test day. Izzie wanted to stand up and get a refill cup of coffee but Cristina wouldn't let her, at least not before she answered the question Cristina asked her. Meredith, Cristina, Izzie and Alex were learning for the intern exam that was coming up next day. They'd been learning for it the past few weeks and Meredith had a lot of free time actually. Meredith was well on her way of passing with flying colors.

She even gives Yang a run for her money.

But she wasn't aware of this.

"If you're not going to let us sleep, at least let me put coffee in my cup." She complained, stretching herself.

Cristina frowned as Izzie started complained. This test will determine the direction of their careers. It was important to pass it. Blondie shouldn't even start, after all she was one of the main reasons Meredith is thinking about leaving Seattle Grace for another program. Cristina couldn't believe this, how did she miss this? Her thoughts circled around that as she told Izzie to do whatever she wanted to do.

"Well, go, no one's stopping you." Cristina motioned her to go for it. "I am just too tired to even stand up." Izzie grumbled slightly. As soon as Izzie said this she nodded off for a slight second and with a thump her head hit the table. Cristina saw that even though she sat maybe two meters away from Izzie, she put her finger over her lips to signal everybody to be quiet so they wouldn't wake Izzie. Then she took a peanut and prepared to throw it at Izzie's forehead. After it hit her, Izzie awakened within seconds and looked up in utter surprise of what hit her. That's when her fellow colleagues erupted in laughter.

"Why are you laughing?" Izzie asked, having the decency to ask what the heck is going on. Meredith didn't answer, she knew that this would cause Izzie to most like snap at her like she always does when Meredith does something she doesn't like or can cope with. But Meredith was going with it, she was being the bigger person. "You've fallen asleep on the table." Alex told her.

"Can we continue on?" Meredith asked, she needed to learn for this test.

This wasn't getting them anywhere and unlike others she had something to prove.

"Geez, we're going to continue with the questions. Izzie, pancreatic divisum." Cristina tested her colleague but Alex Karev was the one to answer the question: "Dorsal duct spincterotomy." Alex answered. "Not your turn but correct- you do me." Cristina told him. Meredith leaned back, wishing she could be with Derek right now or with Cristina at Joe's Bar, getting drunk and talk about stupid boys' penises. But somehow she was daydreaming.

"You have a patient with a tumor near the heart. When the tumor is getting touched, the patient goes into ventricular arrhythmias. Why is this happening and what can happen if it's not treated?" Alex quizzed Cristina. "Oh, that's a hard one but I know the answer to that. Burke asked me the same question when I collapsed in his operating room. The patient's tumor infiltrated the pericardium so it led to arrhythmias. It can cause a tear in the outer heart muscle."

"Way to go, Yang." Alex said.

"Okay, it is my turn." Meredith interjected, grasping a card and read it aloud.

"Alex, this one is for you. What are the symptoms of a fractured skull?" Meredith asked. Alex scratched his head as he searched for the answer.

"Symptoms of a _skull fracture_ are headache, bruises behind ears called 'Battle's sign' or bruises around the eyes called the 'Racoon eyes', clear or spinal fluid leaking out of uninjured ears or nose points towards an open fracture, loss of consciousness and dents, "boggy" or "crunchy" sensations when gently feeling the skull bones." "Skull fractures are common with facial injuries so always check for them if you have a patient with facial trauma …" Meredith added some information of her own.

"Perks of learning with an accredited neurosurgeon, I bet." Cristina muttered, scratching her head.

Derek had told her all she needed to know.

She was well prepared for whatever waited for her. "Where have you put the flashcards with the nephrology questions?" Cristina looked around. Meredith did not know.

"How come O'Malley's missing this? How is he gonna get ready for the test?" "You're kidding right?" Cristina retorted, glancing over to Alex. "We have Callie's cards but George …" Izzie cut in: "George has Callie." "Back to the nephrology questions ... Does anybody know where they are?" Cristina asked loudly. "No." Everyone answered in chorus. Out of sudden, Meredith's pager beeped. It was the Chief. She scanned the pager and then she got up in a hectic and grabbed her jacket before storming off to the door. "Wait, Mer. Where are you going?" Cristina's voice held her back. Meredith hesitated, her hand on the doorknob. "Chief's paging me. There is a trauma and I am kind of on on-call right now." Meredith explained in a tizzy. "I have to go." "I'm coming with you."

"Cristina, you don't need to do that." Meredith declined her offer but her friend wouldn't listen to her. "You said major trauma." When they got to the hospital, a distraught Bailey was already waiting for them.

* * *

**A/N: Please review. **

**I know her wanting to transfer wasn't very foreseeable but I know where I am going with this. Trust me. I won't ruin MerDer. Remember, all cards are still open … I don't know when I will be able to update again since it's the holidays and I am going to Sweden for about a week, which means no internet access. So it'll be awhile before you can expect an update again …**

**Also, I'd like to thank you for the reviews I received. They make my day.**

**Please continue to read!**


	41. Chapter 41

**Chapter 41**

* * *

**There's this thing about being a surgeon. Maybe it's pride or maybe it's just about being tough. But a true surgeon never admits they need help unless absolutely necessary. Surgeons don't need to ask for help because they're tougher than that. Surgeons are cowboys. Rough around the edges. Hardcore. At least, that's what they want you to think. Deep down, everyone wants to believe they can be hardcore. But being hardcore isn't just about being tough - it's about acceptance. Sometimes you have to give yourself permission to not be hardcore for once. You don't have to be tough every minute of every day. It's okay to let down your guard. In fact, there are moments when it's the best thing you can possibly do - as long as you choose your moments wisely.** Meredith Grey; Kung Fu Fighting

* * *

But when they halfway reached their destination a soft vibrate makes them stop dead in their tracks. "Daddy, did you feel that?" Sean asked his father. It feels weird. This isn't meaning something good. "Feeling what, what am I supposed to feel?" The father asked his son as he gripped onto his hand tighter. "This vibrate-y thing – do you feel it? It feels like the building is bending or swaying or something." "No, this can't be, Sean. This building's safe. I am pretty sure of that, my son." The father said. "Now, how about we get you some brand-new soccer shoes for summer season? I am pretty sure you'll be playing in the field." The boy laughed lightly. Then there was a loud crashing breaking noise and people started screaming as the walls gave in. The man grabbed his son to keep him safe. "What … was that?" The boy exclaimed scared. This was scary. "You're right about that, what was that sensation?" The father replies and glances around. Suddenly both surgeons were swallowed up by great, resounding boom. It came out sudden. The father immediately had a thought, an idea of what was maybe happening. And what came into his mind wasn't good. "Come, we need to get out of here. This is gonna cave in soon. I have no idea why and it doesn't matter why. All I know is that we need to get out of here."

After he said that both of them raced to the nearest emergency exit, following the signs as the electricity went out. An emergency generator kept on the signs that signaled where there nearest exit is, in case of an emergency. And this was an emergency. The vibration races from her feet to her spine. Shocked and terrified, he looks up and over to his father who holds onto him tightly. Then there was a loud, deafening screeching noise.

"The wall is caving in." The boy called out in shock, unable to move, he just stood there like frozen.

Suddenly, the father saw that is son wasn't right behind him as he was going down the stairs.

"Sean …?! Where are you? Answer me, please."

But he never got an answer because in this moment the shoddy ceiling was giving in and was burying his son under pile of what used to be the wall. A scream that lets his blood run cold and freeze, he gasped.

He knew it was his son's voice.

Then there was silence. The whole hallway way laying in shambles. People were running around trying to get out of here, to safety.

But he couldn't go, not without Sean.

The ground under his feet moved again, the remaining walls crumbled a bit. He tries to grab the railing to stop himself from losing balance.

In the next moment he finds himself falling and screaming loudly in the process. He had no control over things ... Then, he landed on the ground. On the way to the ground he smacked his against the wall as an earthquake hits Seattle and the west coast with full force. When his head hit the wall, she cried out with an almost unhuman voice. His blood froze when he heard that. He could hear people screaming and running like crazy to find a safe place. The floor seems to be moving. How could a floor be moving? Did something hit the building? Like a plane or something?

Or was it just crumbling down because the building was old and not reliable anymore? However, it does not matter, all that matters is that he finds his son and they get out of here because God knows this building is not safe in any way … He tries to get up but his head hurt and for a moment he lost orientation. Where the hell was he? It was impossible to walk and so ends up on the ground too, sprawling towards the floor as the floor begins to shake.

A paralyzing fear overcomes him.

He can't lose his son.

How can he come back home, looking his wife into the eyes and telling her he has lost their son when the building collapsed?

He couldn't do that. He gasps for air as he looks up hoping to see his son was okay. But his son was nowhere in sight. He then felt bile rising up in his throat and before he knew what was happened he rolled on his side, vomiting on the ground next to him.

His head hurt, that he knew now.

The walls were swinging and ripped into shambles and there are more shrieks and more shouting accompanied from the rumbling of the debris falling to the ground, as if it were raining brick walls - the collapsing building left a wake of destroyed floors and people who are shocked by what has happened in the last seconds.

The building was about to collapse.

"It's collapsing." A man screamed loudly as he tried to get away but was buried under debris in the next seconds. Really, it only has been seconds not as many might think minutes or hours. That's all he remembers before losing consciousness. Darkness engulfed him as he slipped away …

* * *

In the Fire Department, and other Search and Rescue institutions started alarms going off, informing them about the emergency.

Everything sprang into action to help the civilians stuck in the building …

Soon ambulances and others drove off, accompanied by loud sirens and blue lights flickering on top of the before mentioned cars. And a call reached Seattle Grace's emergency room.

* * *

Dr. Callie Torres was covering the trauma department today. It's been slow for now and she's been sitting there, reading a journal about something orthopedic. "You got anything good?" Bailey asked as she joined Callie behind the counter. "Nope, it's a slow day." Torres just replied. "You don't say that. Don't say that it's slow." Bailey said, knowing Callie would regret saying this. "You might have jinxed us. If that phone starts ringing …" "The phone won't start ringing because I am halfway through my extra shift that consisted of covering the emergency room. "Simpler, it is a **_slow _**day." Callie said, looking back into her magazine. "Anyways, what are you reading?" Bailey asked. "Just a medical orthopedic journal, not something that's interesting to you …" Bailey rolled her eyes at her. "What?" Callie asked, not quite getting it. "You still don't say it's a slow day when covering the pit." Bailey told her. "It's like you are tempting fate." "I am not, this is totally ridiculous. It's a slow day." Callie said it for another time. Bailey's brow arched upwards.

"You never say it's sl … you never say it's slow. You just jinxed us."

"It's a day and it's slow." Callie took a sip of her coffee. "I am pretty sure you won't be saying this after the phone started ringing." Bailey only replied.

"Yeah, yeah, sure … I'll be sitting here, reading, nearby the phone in case it starts ringing. Which it won't by the way because it's slow tonight ..." Callie still did not believe Bailey.

"When that phone starts ringing you'd wish you hadn't said that." She noted only.

"Oh, Dr. Bailey, don't be so negative. This is just nothing …" A perky, undeniably nerve-stealing voice said behind them. Bailey turned around and groaned inwardly as she got view of Dr. Sydney Heron. She can't take Sydney's comments about healing with love and so on today. Not today she can't. "The phone's not gonna ring, it is a slow day." Callie laughed. Just then the phone started ringing loudly and penetrant. Bailey watched Callie answer it.

"Go for Seattle Grace Emergency." Bailey watched her attentively with furrowed brows.

She knows what's yet to come, probably incoming. She silently counted the seconds from Torres' face expression to go from bored to highly alarmed.

She watched Callie shot up from her chair, the phone pressed against her ear.

"I'll get the trauma gowns." She ran to get what's needed.

She also needed to page Grey and the others considering it's an emergency.

"Crap, crap, crap … Incoming!"

Callie shouted loud enough for everyone to hear. Sydney watched Bailey run off and Callie quickly starting to organize things concerning the ER.

* * *

„Chief's paging me. There's a trauma and I am kind of on on-call right now." Meredith explained in a tizzy. "I have to go." She added hastily, jumping up from the chair she'd been sitting on for the last minutes of learning for the intern exam. She was almost out of the door when Cristina was following her. The prospect of a possible trauma always trumps learning for intern exam even if Bailey would say the opposite of that.

"I'm coming with you." She called out, grabbing her jacket and followed her instantly.

After a moment, Izzie and Alex followed them as well.

They left the cards lying around on the table and soon they were all in Meredith's car and on their way to Seattle Grace Hospital. Meredith was the one driving.

There was an awkward silence in the car, Meredith tried to ignore it. Her life wasn't a freaking walk in the park to begin with. And the Izzie-thing just made it worse, a lot worse, actually. After a few minutes, Meredith parked the car in the parking lot of Seattle Grace. Dr. Bailey and the other attendings were waiting impatiently for their interns.

"There you are." Bailey exclaimed as she saw her group of interns walking toward her.

"We came as fast as we could. So what's going on here?" Cristina asked eagerly. Dr. Burke cleared his throat and stepped forward, saying something that only concerns Yang and Grey.

"We've cleared our schedule. All non-emergent, elective surgeries for the incomings including the TAVI patient were bumped until further notice. She is rescheduled for the first slot that opens since she's a D1. We need the ORs. Bailey is now giving the assignments. But you should make it quick. The first patients from the scene will be arriving soon."

Meredith listened to what her attending had to say.

Even Webber came down to the ER to coordinate through all of this chaos even though there weren't even patients. Apparently, he had new information about what happened and Alex was right in assuming this. Webber in fact had news about what happened, although it was nothing concrete.

"Alright, people listen up." He said, as Burke finished.

"Okay, I've got word from emergency dispatch. Everybody listen up, this is important." Dr. Webber told the doctors as they were all listening to him.

They've got word about some emergency situation.

Meredith glanced over to Derek.

He nodded almost imperceptible, disaster situations and Meredith - never a good combination. Meredith was thrown back to reality when she heard Richard talking. "We've just received word of a mass casualty incident nearby. All available level I trauma centers have been asked to respond." The Chief raised his voice. Seattle Grace was one of those centers. Every doctor was looking at him, waiting for him to continue.

"I need to send a team to the field immediately. This is not an exercise or a drill, this is an emergent situation and I need all hands on deck." Izzie and the others were all looking at him.

"Seriously, what happened?" Alex demanded to know.

"We don't know yet."

There was no reply coming from any other doctor so he proceeded.

"I don't have details, just orders." He then announced.

"We need to send a team of doctors to the scene to help with the overflow of patients. The other doctors are going to be working in the pit, waiting for the incoming. This is gonna be long day, people."

"Yeah, we all know that." Meredith muttered silently.

Cristina and Alex looked over to her as Bailey winked her interns to come over to her.

"Come on we need to go, Bailey has our assignments." She nicked her head toward her resident who was impatiently waiting for them. "Where are you? Where are my ass-kissing, surgery-hungry interns? Where are they?" She exclaimed loudly as Meredith and all the others from her intern group made their way over here. It appears that they lost view of Bailey, somehow. They didn't know how it could be that they lost sight of their short but definitely skilled resident.

She was just here. "She is over there." George noted from behind.

"He's right, let's go." Cristina said, not wanting to upset the resident.

She wasn't keen on treating oozing bedsores and other things that might count as possible punishment. "I can't have every one doing what they want to be doing." Bailey said as she got view of her interns. "We know, Dr. Bailey." Alex interjected from behind. Meredith on the other hand thought it was best to stay silent in this specific case.

"I don't want to hear it. If I page you I want to be here immediately and not a minute or longer later." Bailey looked at each intern for a second.

"You have heard the Chief, this is gonna be a long, long day." She said, coming now to the important part. "I want everyone on top of their game. Here is not the time and place for mistakes. Got it? No mistakes today, everyone clear?"

Bailey said, glancing at her group of interns to make sure she was understood.

The interns nodded in reply and were signaling that they understood what Bailey wanted from them. Then Bailey did the assignments. "Grey, you're assigned to Shepherd, go." Meredith lit up at the prospect of possible neuro cases. Meredith smiled happily, searching for Derek in the crowd. She saw him talking with Mark. She couldn't help but think that he just looked so hot in his dark blue scrubs. "Stevens, you're on neuro as well."

Meredith deflated like a balloon.

She could have thought of something better than spending her day working with Dr. Stevens. She had been sure she and Izzie had been friendly until it came out.

Right now, Izzie rubbed her the wrong way and she wasn't sure if this would ever be normal.

Probably not, there was just so much history. She was trouble.

Dr. Bailey noted Meredith's look – she kind of looked like she'd just killed her puppy – and just told her to suck it up. Here was nobody being favored so Meredith would have to live with this. Meredith quickly looked to the ground, not wanting to cause a scene on front of the entire hospital.

She was way to mature for that.

"The rest of you come with me to the scene." Bailey continued on.

Meredith looked at Cristina who grinned happily.

Cristina and Alex nodded and immediately started to pack the emergency bags with the equipment they would need at the scene although they had no idea where they were going.

Meanwhile, Izzie and Meredith walked over to Derek who was already waiting for them. Izzie followed Meredith but then she turned and was now walking toward the vending machine, the nearest vending machine they had to the ER.

Meredith shook her head in utter confusion. She really didn't understand Izzie Stevens at all.

* * *

The Chief just told them that they were expecting incoming due to some accident – they had no idea what happened or what to expect but they could deal with whatever happens – Meredith was sure about that.

"Where are you going?" She called after her but never received an answer.

But she didn't really care about that. At least she was on Derek's service. So that was good. So she jogged over to her attending who was waiting for them. "Meredith, there you are." He said, giving her a faint smile. "You don't know where your colleague is?" Dr. Shepherd then asked, he was referring to Izzie as Meredith's colleague instead of roommate. "I think she went to the vending machine. At least it looked like it." Meredith answered, as she shrugged. She didn't waste any time in thinking about Izzie's whereabouts.

"I'm sorry. I just went to the vending machine to retrieve some snacks for later." Izzie perkily exclaimed, not addressing or simply not noticing the awkwardness and tension in the room she was met with.

"We've got incoming, Stevens. Your duty as a doctor is it to know when to do what needs to be done and something like this always comes before that." He pointed unmistakably to the power bars in Stevens' hands.

Meredith only watched the scene.

Meredith knew she should have thought of turning on the TV prior getting in the car, in the hope there was a breaking news report telling them what has happened.

Some catastrophe has happened. In the next moments a few ambulances with wailing sirens pulled up on the ER entrance. Callie and Alex got gowned up and ready. They don't know what has happened, but they know it's huge. After the first ambulance pulled up, the doctors waiting for the patients but soon they saw that the patients were lost causes. They've been trying to get them back for like forty minutes and still nothing. "You just have to call it." The paramedic said. "What the hell happened out there?" Alex asked out aloud, asking the question everyone was wondering about. Meredith and Derek waited outside for the ambulance.

They could hear the sirens wailing and thereafter the ambulance arrived.

The dark-haired paramedic jumped out and opened the back of the ambulance. In this moment, another ambulance was arriving, this time with a head trauma, obvious head trauma. Meredith instantly saw the dent in the patient's skull. Izzie was nowhere in sight. But that was not important right now.

What was important was to treat this patient quickly and effective.

"Oh my ever loving …" She muttered, nobody was able to her. They needed neurosurg, now. She was turning around and motioned Derek to come over. He immediately responded. This was neuro. Izzie was right behind him and determined to make this hell for her and the paramedic reeled down the facts while they were pushing the patient in Trauma room 3 after Derek's order. "24 year old female is presenting with facial and suspected head injuries." "This looks bad." Derek stated, frowning. Meredith looked at him. She knew this face expression. "Closed head injury. Increased intracranial pressure, GCS is 6. She was hypotensive en route. We intubated and sedated her at the scene due to airway protection to avoid hypoxia. She's been able to open her eyes before that, she also responded to pain stimuli." The paramedic stated the facts. Derek nodded in reply. "Page Sloan, we will need him for the facial injuries." Derek ordered stiffly, as he checked the function of the pupils with his penlight. Hypotension and hypoxia were independent predictors of a poor outcome. Meredith knew it, and he knew it. The patient's neck was immobilized with a StiffNeck to prevent further injury and the patient had a GCS that was more to the low side and therefore indicating something more serious than just a concussion.

Concentrated, he evaluated that this patient needed a CT.

„Clear a trauma bay right now, move it." Derek ordered in a hurry.

They wheeled the patient into trauma room 3. Before the paramedic walked back to his rig, Meredith quickly asked what happened at the scene. "A building collapsed." She answered shortly. "I have to go." She said as via radio another call came in.

They were needed at the scene and so was Meredith in trauma room 3 with her patient. So she got back to work, checked for additional injuries, did the trauma series. Meanwhile, Meredith palpated the patient's abdomen. "Dr. Shepherd what can I do?" Izzie's perky voice sounded through the room, interrupting the sound of the monitors. "Go to the wall and stand back or do me one favor and get this to trauma lab, I need these values ASAP, this is gonna be hectic." Derek watched the heart monitor. "I know, this is not my first …" Izzie started to say, her gaze going to Meredith who was doing a central line.

"You sure act like one, wall. Now, if possible for you!"

Derek's voice was cold and there was no place for making a scene. "Shouldn't you be giving her anticonvulsants to avoid seizure-induced hypoxia? What about steroids?" Izzie half asked. Meredith looked up. As far as she knows, giving steroids in patients with head trauma isn't appropriate. "You don't give steroids in patients with TBI since they've found to be ineffective." Meredith explained whilst doing her job.

Immediately some ER personnel reacted and did what Derek wanted to from them.

"Make sure CT is on standby. If there´s a bleed or something and I need to go in, I want an OR prepped and ready the minute I know what we're dealing with."

Meredith had started examining the patient thoroughly, not only head and face but also the other parts of the body. "Of course, doctor." The nurse quickly replied and contacted OR. Meredith and Derek were in the trauma room, trying to stabilize the patient, but they couldn´t get his blood pressure up. „We need to consult plastics. Her face is fractured. Page Dr. Sloan. And then get her to CT." Derek instructed, while testing the patient´s pupil reaction.

"We'll page him right away, doctor."

A nurse said before paging Sloan to the trauma room right away. Derek Shepherd looked over to Meredith before asking a question. He was assessing the patient's state, if she was conscious, if there were other neurological deficits. It was pretty obvious that there was trauma to the head. Her pupils were a bit sluggish and one wasn't really reacting to his penlight. She was already putting in a catheter to measure the intracranial pressure.

It would tell them if there are any spikes that needed to be treated.

"Symptoms of Traumatic Brain Injury are loss of consciousness, dilated pupils, or pupils of uneven size, spinal fluid coming out of the ears or nose, vision issues, such as blurred vision, double vision, light sensitivity, inability to move eyes, or blindness, balance problems, dizziness, respiratory failure, or problems breathing, slow pulse, and slow breathing rate, with an increase in blood pressure, vomiting, inability to respond, not alert, sluggish, sleepy, or easily fatigued, headache, confusion, or difficulty with thinking skills such as memory and judgment, odd emotional response, difficulty speaking or swallowing, numbness or tingling in body parts and bladder and bowel control problems." Meredith answered while working on the patient.

Izzie was alarming the CT and the OR of a possible patient so that they were warned and they would keep open a spot for them so that there was no or little waiting time.

All of them knew that they were walking on borrowed time … that time was crucial.

* * *

"I need to send a team to the field immediately. This is not an exercise or a drill, this is an emergent situation and I need all hands on deck." "Seriously, what happened?" Dr. Bailey demanded to know. "We don't know yet." Richard answered his question. "I don't have details, just orders." He then announced. "We need to send a team of doctors to the scene to help with the overflow of patients. The other doctors are going to be working in the pit, waiting for the incoming. This is gonna be long day, people." He warned them.

Cristina, Alex and George were packing their emergency kits, placing disposable gloves in it. "Come on, hurry up. We're catching a ride with Seattle 34. Space is tight so hold your kits in your lap." Their resident ordered.

"Where are we going?" Cristina asked, she needed to know where they were going. "We'll know when we get there." She got a short answer from Miranda Bailey, who was in full-on surgeon 'I need to triage' - mode. "Fire, flood, volcano … I am not really dressed for a volcano or in the mood to deal with erupting volcanoes." Yang said while they walked outside. "Yang." Bailey scolded her intern. "Sorry, that was inappropriate." Cristina quickly apologized. Nicole was waiting by the ambulance whose rear doors were wide open.

"Whoa, whoa, whoa, I am hauling supplies. I have only space for three." Nicole, the paramedic said.

Bailey looked over her interns and said: "O'Malley."

"Yes, Dr. Bailey?" He asked, hoping he wouldn't be asked to stay here.

"Stay with the Chief and take care of the incoming wounded." Bailey told her. "The rest of you come on." "Cristina was the one with the inappropriate comment." O'Malley protested. Cristina looked at him angrily. George had no choice but to do what Bailey says which sometimes really does suck. But he did his job because he was not Izzie who complained every chance she got. Then the doors closed and the ambulance drove off. Sirens were blaring loudly. Alex and Cristina were sitting in the ambulance and were on their way to the scene of the accident. Bailey was there as well.

It was a silent drive … nobody was talking – at all. That was before Bailey started speaking. "Everybody move your IDs to the outside of your jacket. When we get there, remember triage, Karev, name it?" Bailey asked.

"Green tags, non-emergent, yellow – delayed care and red tag needs immediate treatment." Alex answered. "Assess carefully. Tag and get all critical patients into the ambulances as fast as possible. Don't get in the way of Search and Rescue and stay calm." Bailey warned them.

"Any word what happened?" Alex asked a question everyone wanted the answer to.

* * *

Dr. Sloan waited for them in CT. "Seems like someone needs a plastic surgeon." Mark said cockily. Meredith scowled. Now wasn't really the time for this. She shot him a look and immediately, he got somewhat serious. What do we have?" "A building collapsed and he suffered traumatic brain injury and possible facial injuries, that´s why we paged you. We are still waiting for the images to come up." Derek answered quickly.

After a while the images were up.

"Damn, he's suffered major trauma to his brain and face. What about the other trauma scans? Did you do scans of his neck and spine as well?"

"We did the trauma series, and with that we've covered about everything." Meredith replied while assessing the monitor with the brain on it.

"Well, that´s not all. What can you see, Dr. Grey?" Derek directed to Meredith, who studied the monitor carefully, before answering: "Acute Subdural Hematoma and there are also signs of contusion. He needs an emergency craniotomy. Causes of acute subdural hematoma are major trauma and it has a mortality rate of 50%. It's a clot of blood that develops between the surface of the brain and the dura mater, the brain's tough outer covering, usually due to stretching and tearing of veins on the brain's surface. These veins rupture when a head injury suddenly jolts or shakes the brain."

"What is a SDH?" Derek directed his question to Stevens who seemed to have zoned out for a moment in contrary to Dr. Grey who was intently gazing at the scans that were there.

"SDH …" She repeated slowly.

"It can be chronic / subacute and develop over days or weeks or it is acute." "What about this one?" Doesn't she know how to read a CT scan? Wow, that's just embarrassing. "It's …" Izzie started. Meredith groaned inwardly. She knew they were walking on borrowed time. While Mark went to get the patient out of the machine, Meredith watched Izzie's poor attempts to score points with Derek.

She _saw_ the patient was bleeding into the brain.

It was a left-sided subdural hematoma, acute with a midline-shift.

Derek's face showed a hint of annoyance, only Meredith was sensing it and maybe Sloan – since they've been friends since, like forever.

"It's a left-sided subdural hematoma that needs to be evacuated immediately since there are already signs of raised intracranial pressure. There's another reason leading to its surgical removal. It's greater than 1cm at its thickest point." Meredith interrupted while pointing at the CT screen.

"Well, then let´s get him to an OR, before he bleeds out."

The surgeons rushed the patient to the OR, but there weren´t any ORs. "How come there is no OR available? I have an emergency craniotomy or my patient will die." Derek was furious. The nurse stuttered helplessly: "I can´t do anything about it." "Well, bump any non-emergent patients. Clear the OR rotation now and maybe someone just started operating. Maybe they can close up until further notice. I don´t care, just get me a damn OR." The nurse nodded and reached for the phone. "That seemed to work. Have you seen her face? She was terrified of you."

"Mark." Derek hissed and instantaneously, Mark got serious again.

"What is the surgical plan?" Dr. Sloan commented.

"I will go in first to relieve the intracranial pressure and when I am finished we can talk about what to do about the facial injuries? How does that sound?"

"Good. Will you page me when you´re done operating?"

"I will." Derek replied. The nurse interrupted with: "OR 2's ready for you." They rushed the patient into surgery. Meredith assisted Derek in surgery as did Stevens. Brain surgery was interesting. The brain was a mysterious organ. That is why the brain is so interesting. But Stevens wasn't nearly as concentrated as Meredith.

Derek caught her repeatedly while glancing at the clock.

"Stevens?" He suddenly asked, interrupting the quiet in the OR. It was quiet in the OR. Any loud or disturbing noises weren´t welcome, because it was important to concentrate for all the surgeons to concentrate. "Can you tell me what an epidural hematoma is?" "But this patient has a subdural hematoma, why are you asking me about this condition when the patient is suffering from another type of brain bleed?" Izzie asked, confused about the mere fact that Derek was indeed quizzing her.

"In case you haven't noticed, Dr. Stevens, this is a teaching hospital. I am supposed to teach you guys and get you ready for the intern exam. If you're lazy or just don't care about this stuff then my advice is to you to quit this job. So, back to the epidural hematoma ..."

Izzie racked her brain for an answer.

She couldn't fail again. This is what she wanted – to be on neuro and shine. After she answered – correctly – Derek asked another question.

"What is an intra-parenchymal hematoma?" He asked her. Izzie flinched as she heard him asking her a question and she wasn't able to answer it. She knew the differences of epidural and subdural hematoma but intra-parenchymal hematoma?

"So I guess you don't have an answer, right?" Izzie stayed silent.

"I take that as a no." Derek only replied as he continued on with the surgery. "Does anybody know the answer?" He threw the question in the room, meaning he proposed the same question to Meredith who was – thanks to Derek and his flashcards he made as a neurosurgery fellow – able to answer the question with absolutely no difficulty.

**Later:**

"Can you see that?" Derek asked and Meredith nodded. "That's the bleeder, right?" Meredith tried to get a view of the operating field. "Yes, you're definitely right." Derek responded. "I am starting to remove it. Suction, now." Derek voiced.

Izzie nodded only, for once without snazzy remarks.

Everyone in the operating room enjoyed the silence. "So … I got it." Derek happily announced.

Meredith started clapping and soon the whole OR staff joins her.

* * *

"All we know is multiple traumas." Bailey answered. Then the ambulance came to a sudden hold. Bailey was the first one to stand up and open rear doors. The others quickly followed him outside only to be greeted with the sight of something horrible. Bailey helped them out of the ambulance, Cristina stopped abruptly when she saw the disaster scene so that Alex crashed into her. "Yang, you're in my way." Alex startled her by addressing her. Cristina was still focused on what she sees. A building collapsed. There were many injured, she saw Search and Rescue going in, trying to help people who are stuck in there. Sirens were howling loudly, when Cristina didn't react, she hit a smack in the arm of Alex who was calling her name.

Bailey was already off to help patients. "Come on, Yang. There are tons of people in there who need medical attention right now." That got Cristina to move it.

Soon both surgeons were on their way through tons of what used to be ceiling or floor … only stopping for patients that needed them. The house collapsing had left a trail of destruction. All changed when they've found a kid stuck under a pile. "Help ..." He called out in a weak voice. Cristina stopped when she heard the call she lets the emergency pack fall to the ground and started looking. "Cristina, what …" Alex asked confused.

"I heard something. It sounded like a child, stuck under something and therefore not being able to move. Remember the guy? He was constantly asking about his kid …" "Oh, crap." Alex said as it dawned on him. This day sucked big time. After they had the kid stabilized the got him into an ambulance and rode with it back to the hospital whilst working on the boy.

"What happened?" Dr. Webber and Dr. Burke asked almost simultaneously as Alex was pushing a gurney with a patient laying on it.

Cristina was bagging the patient. "We did ATLS protocol but he's …" Alex started as they entered the ER. "I was paged?" Arizona Robbins arrived, she panted a bit from all the running. "Talk to me." She ordered as she glanced at the patient, noticing the bloody bandages. "We inserted bilateral chest tubes, but he kept on bleeding in the field. He was talking at first but unconscious en route. Then he started bradying down so we pushed atropine. I opened his chest when we lost vitals. Found an edge of the rib protruding into his ascending aorta so I attached a clamp and was able to get some heart activity. But he's barely hanging on now." Cristina finished stating the facts.

Arizona and the other doctors listened to them and the pediatric surgeon quickly pulled out her stethoscope while asking: "You got an OR lined up?"

Alex nodded. Cristina and he had been sharing the work.

They'd been working as a team.

"Good work, the both of you are scrubbing in. I need all the hands I can possibly get."

* * *

Alex and Cristina were both assisting in there. Arizona Robbins and the cardiac surgeon Dr. Burke were working on saving the kid's life. The Chief had been called away to another emergency. "Can you hold the retractor, please?" Alex asked Cristina. "Sure." She replied, replacing Alex's hand with hers. They were working as a team, what wasn't a sight of Cristina you get to see very often. Alex looked down at the surgical field before saying: "He'll need a 3-0 Prolene and a Gore-Tex graft. I'll get it ready."

Cristina let Alex do it because she knew he liked pediatrics so why shouldn't he get to do the procedure?

However, she watched it closely. Arizona smiled under her mask. But that was before the patient's heartbeat became somewhat erratic.

"Oh no, I think he going to crash … and that soon." Cristina noted anxiously as she looked at the monitor. Before the doctors could do anything the patient started crashing.

The heartbeat became more and more irregular and monitor signaled with a rapid and erratically tone that the patient had gone into ventricular fibrillation. "Damn it." Arizona muttered under her breath but stayed calm, before shouting: "I need a crash cart now." Cristina immediately responded. She handed the paddles.

„Charge to 200. Clear!"

She shocked the patient once, but he didn't respond, neither to the first round of ACLS drugs or to the shock. "Charge again." She pressed the paddles to the patient´s chest. "Clear." The next shock sent the patient´s body flying upwards and back on the table. After three rounds they were able to revive him. "We really need to get this done.

The sooner he gets to ICU the better it is." Arizona said as they patched the aorta where the rib had done the damage after they clamped it.

* * *

After a successfully completed surgery, Derek let Meredith close which led Izzie to seethe jealousy. "Why is she closing? I'd like to as well. You're favoring her." She accused Derek who turned around to look at the upbeat and very often distracted intern before answering her. She'll get her turn at some point. "Wrong, you're wrong. Dr. Grey gets to do this because I trust her instincts and I know she can do this. She should be the one doing this. But Meredith did it perfectly. He was watching her precise moves she made with the scalpel. Derek was watching over every step she did to assure that she was doing extraordinary job which she did.

His soon to be wife truly had a natural flair for neurosurgery.

She was good at that. "Good job, Mer." He nodded his head while his eyes looked warmly at her, for a moment both of them were forgetting what Meredith was thinking about. Derek wanted nothing more than to get her to stay in Seattle. But he also knew that once Meredith decided there was nothing that could get her rethink what she wanted to do. And that's what he feared.

He didn't want her to have to move to some other city or state just because one of Meredith's intern colleagues had a thing against her because this is where this is going. Their patient was ready to be moved to post anesthesia care unit.

He had Meredith and Izzie manage her care, hoping they would not do anything to endanger this patient.

With Meredith alone, he had no doubts that she would do it but in this case, there was Izzie as well and they weren't such a good combination in the moment.

"Dr. Shepherd, we've been able to track down this patient's family. They are living in Vancouver and are on the next flight to Seattle." Derek nodded. "Well, page me when they arrive so that I can inform them of her condition." In this moment, his beeper shrieked for another time. He glanced on the screen: 911 ER. Derek threw another cautious view on the patient's monitors to assure that CPP and ICP and heart rate were all in the normal range. After he was satisfied with what he was seeing, he turned around before calling out for Meredith and Izzie. "Come, we have another patient waiting for us in the pit." Derek announced loud enough for Meredith and Izzie to hear. Their patient was now laying Neuro ICU for the time being. The nurses have contacted the family and they're coming down from Vancouver, Canada.

But thankfully, Vancouver wasn't that far away from Seattle. When they got back to the ER, there were still a lot of patients. Callie Torres was screaming at some medical personnel not to let a gurney block the hallway because they needed the access, soon after that she was called away to a major trauma case with a lot of broken bones, a broken pelvis …

* * *

"Okay, we're here." Derek said as he moved quickly through the ER.

But a nurse told him that their patient was already in line for CT and not here anymore. "They told us to tell you to meet them up in CT since his condition's deteriorated. He's a father, his son is being cared for in another operating room but they should be finished soon."

"Stevens, let's go. There is a patient waiting for us in CT." He said and started running.

Izzie had trouble keeping up with him. She panted but Derek kept up his pace. Then they reached their destination, the viewing room. CT scanning is the preferred acute imaging modality, because scans can be performed quickly. CT scan findings help identify abnormalities that may need acute intervention, Stevens knew that. The images aren't up yet, Derek saw at first glance. "Do you have a patient history?" He asked nobody specific.

Izzie grabbed the chart and read aloud.

"John Hawkins, thirty-five, patient presented with a severe, persisting headache at the scene, also complained about nausea and vomiting and paramedics noted increased drowsiness and a slurred speech. He was intubated upon arrival at Seattle Grace."

"The scans aren't up yet. So what about a little education about possible differential diagnosis's, what do you say, Stevens?" Derek smiled. Stevens nodded, partially giving up resisting, knowing it wouldn't work. "Go for it." "What causes cerebral contusions?" "Causes are … Direct trauma to the head or acceleration / deceleration-injuries cause this kind of injuries." Izzie smiled happily when she found the correct answer. For once she didn't embarrass herself further. But Derek wasn't satisfied, not just yet. She was giving Meredith hell.

That's why he can make her life hell by asking her about complex neurological conditions in detail. It was his job to teach her and he was doing that by asking questions. Derek wasn't satisfied.

"What the pathology of contusions?" Derek asked, his eyes fixated on the monitor, waiting for the pictures to come up at the screen. He heard Izzie Stevens answering his question. "Most contusions represent the brain coming to a sudden stop against the inner surface of the skull – that's also called _contrecoup_ – accentuated by the natural contours of the skull." "What about epidural hemorrhages?" Derek asked. In that moment, the films showed up on the computer screen. Derek instantly forgot about wanting to teach Stevens. "Oh, damn it. This is worse than I thought." Derek looked at the screen and at the axial CT scan they did to check for any bleeders, contusions. The radiology tech did as well, he knew what Derek meant. Stevens was the only one who seemed lightly confused about something.

Then she saw it: acute brain contusion.

"The axial CT scan that was obtained in a patient immediately after injury demonstrates a large, right frontal contusion with hemorrhage and surrounding cerebral edema." The tech said at first. Derek nodded in agreement but there was something else. He saw something else on the screen. "There's a smaller, subtle, right temporal cortical contusion, as well as a left frontal epidural hematoma." Derek turned around to Stevens and said.

"Book an OR. We need to do a resection of the contused tissue due to swelling that puts the ICP above an acceptable degree. We're not letting this brain herniate."

* * *

"I can see a temporal scalp laceration with associated hematoma." Meredith said, quickly assessing her patient, her solo patient. Cristina would be so jealous if she knew what Meredith was doing right now. She looked over the monitors. Her patient was sedated and intubated since she had maintained airway, just as precaution since GCS had been below nine. She had a nurse, Olivia, helping her in there, assisting. But she was totally capable of doing this herself. She felt like she was bullet-proof, like nothing and anything could harm her right now. She was working on a neuro case solo. "So I say, I start with irrigating and then explore the wound, followed by a repair of the laceration. I need irrigation, please." Meredith said as she asked the nurse for the needed supplies the nurse handed her with a quick smile.

The tray with the supplies was right there. Olivia noted: "But you should also …" Meredith shot Olivia an expressionless look and cut her off: "… also get a CT to rule out intra-cerebral hemorrhage, a contusion or cerebral edema. I know my stuff. I would have always done a CT because that would have been irresponsible." Meredith said as she finished with irrigation. "I am now exploring the wound." Meredith said concentrated as she was cautiously exploring the wound. "Damn it, we've got an active bleeder." The wound had started to bleed again.

"What the hell do I do? Staples aren't a good idea since it's his face … Glue, if wanted to maim him permanently." Meredith wracked her brain for something, a solution. "Dr. Grey, what do you want to do?" Olivia's voice caused her to snap back to reality.

"I am thinking." Meredith said, breathing deeply. "Then think faster." The nurse replied.

"You need to stop this bleeding now." Then she got a solution, tamponades the bleeding and was finally able to stop it.

She breathed a sigh of relief. She was not screwing this up. This was her chance to prove everyone what a good doctor she was. "Grey." She suddenly heard her name, someone was calling her name. Meredith's gaze went to her patient's heart monitor and then to – surprise – her resident.

Bailey's eyebrows arched as she took in the scenery. Meredith alone in a trauma room attending to neuro trauma case … She shook her head in surprise. "You're on this alone?" She asked hastily. Meredith frowned before nodding. "Need a hand?" Bailey continued. "Not really necessary, I got this, Bailey. Shepherd told me to handle this case solo. I was just about to do his scans." Meredith explained. "Well, he's got a gash on his forehead so you might want to stitch that up first." Meredith chuckled slightly. "Yeah, I was definitely planning on doing that first and then I am taking my patient up for the scans."

"So, I'll leave you to it."

Staying true to her words, Bailey soon left Meredith. Meredith took her patient up for a set of scans. Meredith waited for the results to come up on the screen.

**Later:**

Meredith sat in her patient's room and monitored his CPP and ICP and additional vital functions after she discussed the results and the treatment plan with Derek.

But for now it was looking good.

Her gaze went to the patient's ICP monitor, a device used to measure intracranial pressure inside the brain. She'd administered the meds and was now observing him.

Derek was operating with Izzie assisting. She was still angry and all about Meredith and about her getting the solo patient. Derek wisely ignored the bickering of his intern assisting in an attempt not to make it worse. It's not that he cared about the fact that she was angry about what Derek decided it more about the work atmosphere.

Then he focused back on his patient and continued with the surgery. "Stevens, I need you to retract so can get better visualization here. I'm starting to remove the contusions." He slowly said as he made the move.

Derek Shepherd just finished a long and tiring surgery.

The man he was working on, had sustained serious brain injuries.

"So, I'd say we're finished and good work everyone." Although he needed to ask for suction and other things Meredith would have known to do before he knew he needed it. She was thinking steps ahead and that was good. She will make a great surgeon one day, after finishing her residency. He'd be happy to be having her as his fellow, as his student. After Derek finished giving out instructions concerning the patient's post-op care, he scrubbed out. In the hallway he met Arizona and Burke standing there, talking about a patient.

"Hey, you've finished surgery on the son?" Derek Shepherd asked as he was coming nearer. But before any of them could reply, a perky and timid voice interrupted him. "Dr. Shepherd, is there anything I can do for you?" She looked at him with big eyes. "Yes, actually there is. You can monitor both patients we got in today. Watch for any spikes in ICP." Derek gave out orders.

"Isn't …"

"You go do monitoring on post-op patients. They're both critical and need to be monitored."

She deflated like a balloon at his reaction. She'd hoped she could stay and listen what the grown-ups are talking about.

* * *

But since she didn't want him to get even more angry at her than he already was she went and actually did what he said. She can't believe he's gotten short with her (although that hasn't really been the first to happen). Derek looked at Izzie's retreating back. He was sure Meredith was still monitoring her patient. After making sure Izzie did what she was supposed to do he turned his attention back to his fellow surgeons.

"Yeah, we've finished surgery on the boy. He's in pediatric intensive care unit now and is doing as well as can be expected after such a surgery and this much trauma to the body." Arizona told him, partly exhausted.

The father got out of surgery as well. He had suffered an intracranial hemorrhage and a cerebral contusion that was confirmed by a CT. He was then rushed to the OR which was luckily prepped and ready. He got out of surgery only hours later and was presenting as stable ever since.

"I just finished surgery on the father. He's stable but still critical. Okay, there are some charts that need to be updated and I think about doing that now." Arizona said before leaving and sitting on chair, grabbing the chart. Her face lit up when she saw the orthopedic surgeon leaning against the counter. Derek followed her gaze. She knew she had a boyfriend so chances are she isn't even gay. But she still has a little crush on Callie Torres.

Suddenly, Callie noticed someone was looking at her and glanced over to the PEDS surgeon.

Arizona bowed her head immediately and focused back on the files she was completing. Sure, they had interns for this but this case was complex so she did it herself. When she looked back up she saw that Callie was smiling at her.

"Hey, Shepherd, heard you gave Meredith a neuro patient to handle solo?" Dr. Webber said as he joined into the conversation.

"Yes, I did." Derek smiled warmly.

It had been a good, well-thought decision that paid off. Meredith had been flying solo or at least halfway solo.

"Well, I heard she did good. Bailey and I agree on that one. She told me about it. She was in the gallery when Meredith ran down the specific treatment. What I wanted to say was that she has potential. I have seen many residents come and go but not many with such a potential, it would be a shame if we didn't support it. Do you know by any means what she wants to specialize in?" Dr. Webber asked.

"I was thinking about upping her hours in neuro to get her a well-rounded education in neurosurgery." Derek's face lit up. Maybe this was the key for everything. Dr. Webber just gave her a reason to stay, even though she didn't know it. Derek would have to talk about that with Meredith. But before he could make a move to do that his pager beeped again. Derek groaned slightly. This had been one hell of a shift, back-to-back surgeries and apparently it was not about to end for another little while.

"Well, go answer it." Dr. Webber motioned toward his pager.

"Yeah, will you. Anyway, I need an intern." Derek said. Dr. Webber grinned, both exchanged smiles. Dr. Webber knew what intern to send to help Derek. It was obvious after them talking about letting Meredith spend extra time in neuro.

"If I find Meredith I'll send her to you." Derek chuckled.

Soon they were standing in the OR, operating on fixing an intracerebral hematoma in combination with a skull fracture without any other interns annoying them. Meredith knew all the answers Derek asked her.

She knew that generally, patients with small intracerebral hemorrhages and minimal defects are treated with medication and patients who have cerebellar hemorrhages who are deteriorating or who have brainstem compression and hydrocephalus, are treated surgically to remove the hematoma as soon as possible. Patients with large lobar hemorrhages who are deteriorating usually undergo surgical removal of the hematoma. Halfway through the surgery, there were some complications with the intracranial pressure but after pushing mannitol they could continue with the surgery and finished it …

It was a good day. Shepherd hasn't lost a single patient. Well, he could have. After a long shift, Meredith and Derek went home.

* * *

**A/N: Thank you for reading. Also, a big thanks to those who have reviewed my story.**

**An epidural hematoma, also called a hemorrhage or a bleed, occurs when there is bleeding between the dura and the skull. The blood can pool, quickly causing an increase in intracranial pressure. A distinguishing feature of epidural hematoma is the lucid interval. The patient experiences a loss of consciousness, recovers for a time, but then begins to deteriorate. This is a sign of increasing intracranial pressure and requires immediate surgical intervention. Epidural hematoma can also occur in the spinal column, leading to motor deficits and other peripheral neurological symptoms. Treatment for this condition can be successful with excellent outcomes, when correctly and promptly identified. Untreated, it can lead to brain damage and death.**

**A brain contusion is a bruise of the brain tissue. A brain contusion is caused by small blood vessel leaks. Because they involve structural brain damage, contusions are more serious than concussions.**** Contusions are most often found in cortical tissue, in areas that are near sharp ridges on the inside of the skull, such as under the frontal and temporal lobes and on the root of the ocular orbit. The prognosis for contusion depends upon the severity of the injury. Symptoms are memory loss, attention problems, confusion, emotional disturbances, difficulty with motor coordination, numbness and loss of ability to understand or express speech. More severe contusions lead to swelling in the brain, which can cause additional brain damage.**

**Cerebral hemorrhagic contusions are a type of intracerebral hemorrhage and are common in the setting of significant head injuries.**


	42. Chapter 42

**Chapter 42**

* * *

**No one believes that their life will turn out just kind of okay. We all think we are going to be great. And from the day we decide to be surgeons, we are filled with expectation. Expectations of the trails we will blaze, the people we will help, the difference we will make. Great expectations of who we will be, where we will go. And then we get there. We all think we're going to be great and we feel a little bit robbed when our expectations aren't met. But sometimes our expectations sell us short. Sometimes the expected simply pales in comparison to the unexpected. You got to wonder why we cling to our expectations, because the expected is just what keeps us steady. Standing. Still. The expected's just the beginning, the unexpected is what changes our lives.** Meredith Grey; Great Expectations

* * *

Meredith and Derek got home after a hectic day in the Emergency Department. Most of the time, they had spent in the operating room. Derek waited by leaning against the door of the locker room, waiting for Meredith to switch into her street clothes. Whenever Meredith looked at him, she noticed that thoughtful frown on his face. When they were walking toward their car, Meredith tried to figure out whether to say something or ask him about what was wrong. She guessed it had something to do with her plans to move and transfer her residency. Maybe he and Webber had talked about something that left him with no choice but to do it. Should she just ask him about what happened? Maybe it was or is somewhat relevant for whatever reason. "Derek?" Derek turned around when he heard Meredith saying his name. Meredith cleared her throat before continuing to speak. "What's going on with you, Derek? You seem different." Meredith observed. "Well, my fiancé is moving across the continent and I should be okay with it?" The young surgeon sighed. She should have known that this was about that and nothing else. She should have guessed. This is why Derek's acting like this. "Can we for once not discuss this?" Meredith pleaded. "Meredith, we need to talk about this." Derek said, his voice shook a bit.

"What about a little bit normalcy in this whole scenario?" Meredith asked.

"For one day, I just want it to be me and you without discussion over my residency or any other work-related issues." With that Meredith opened the door of the car. Derek was driving the car. The drive back to the house was silent.

Nobody talked or wanted to make the first move. They would most likely come to a similar result as last time's discussion. When Derek stopped at Meredith's house, she left the car without acknowledging him. Derek sighed.

He doesn't want it to be like this.

Meredith's thoughts went back to the day after she worked all this overtime.

It started out as a normal day, with breakfast in bed. But Derek also wanted to talk about why she wanted to move and which places she actually considered …

He didn't know anything.

* * *

**Flashback**

Meredith_ was so relieved when she was finally home. She had no idea how she made it home, how she made it home without an accident. That was a miracle by itself. She vaguely remembered parking her car next to her house and opening the front door. Bed. A bed is all she wanted. And maybe food would be good for her. Some cold pizza would have to do it. She didn't have the energy to order something. Her energy resources were used. She walked into the kitchen, her eyes were barely open when she opened the fridge. But besides some old cheese was nothing in there, at least nothing eatable. "Ugh." Meredith mumbled, she gazed around the kitchen. Her glance settled on a chair. She doubted she will make it to their bed and she didn't want to wake up Derek who was probably still sleeping. She could feel her heart beating in her chest as she let herself fall on the chair, putting her arms on the table as her makeshift bed. She could fall asleep right on the kitchen table. _

_And she probably will, it's just a matter of time. _

_Suddenly, there were footsteps coming from upstairs. _

_Meredith looked up, warily. It was probably Derek who had heard her come home. It can't be one of her roommates because they're all at work. And she was right, it was definitely Derek who came down the stairs. Meredith was relieved, maybe he would carry her up. _

_It seems like Derek had noticed someone came home. He walked down the stairs and was shocked to see Meredith in that state. _

_He instantly saw how bad she looked. She was pale and tired. She lacked energy. _

_She didn't look good. "Meredith, you're home." He exclaimed, coming over to her. She'd clearly overdone it, he saw it. Meredith looked into the handsome face of her soon to be husband who gasped as he got view of her exhausted features. _

_"I'm fine." She mumbled, barely coherent. The purplish circles around her eyes, the bloodless lips – he was all painfully aware of that. "Just bed." Meredith mumbled, barely able to get onto her feet. "What about food, Meredith?" Derek asked worriedly. "I will eat tomorrow. Now I just want to curl up and sleep. Sleep is all I want." Meredith tiredly said, pushing her up. "Today is tomorrow, Meredith." Derek waited for a reply but there was none. Instead, she pushed herself up, supposedly heading for the stairs. This wouldn't end well for her. _

_"Wait, I'll carry you up. You're too tired. You'll just tumble down the stairs in your state." _

_Meredith looked at him tiredly. "Anything you need to do to not let me have to be treated in the hospital, again." Gently, he lifted her up and carried her upstairs where he laid her down onto her bed. _

_"I love you, Der." Meredith mumbled, only moments before she fell asleep. "I love you too." He said to the sleeping figure. _

_He told himself he would prepare a good breakfast for Mer when she wakes up. Like scrambled eggs or something like that. Meredith slept for twelve hours straight. _

_She never even stirred, Derek just sat there listening to her breathe and snore. _

_He chuckled at her snoring, he wondered once again who such a tiny person could make so much noise. By the time she woke up he'd prepared a fresh breakfast, a healthy breakfast consisting of fruits, whole grain bread and orange juice to regain energy, supported by previous sleep. He wanted to surprise Meredith. _

_He also made scrambled eggs._

_"Morning, sleepyhead, are you ready for breakfast?" He smiled at Meredith who was right now waking up. "Derek? You're already up? It's too early." Meredith rubbed her eyes and squinted for a moment before glancing at Derek who held a breakfast tray in his hand. "And what is this?" Meredith asked. "I thought I'd surprise you with breakfast. You must be hungry since I know that you've skipped dinner." "Because I was tired …" Meredith reasoned. "And now you must be starving." Derek replied. "Come on, Mer. Sit up and we're having a little breakfast in bed, just you and me." He smiled his McDreamy smile at her. "Have you planned this?" Meredith asked, her eyes brows arched up as she looked at the tray Derek was holding in her hand. He put the tray on his nightstand and sat down next to Mer who kissed him quickly on the cheek. "Love you, Derek." She chuckled lightly before her eyes darted to the tray. "Come on Derek hurry up I am hungry." Meredith pressed. _

_"Well. It's absolutely safe to say that I am not surprised after what happened yesterday morning." Derek chuckled. When they both were sitting in a comfortable position, Derek positioned the tray between them. _

_"Derek." Meredith exclaimed surprised. "When did you make that?" She asked, her eyes lighting up as she said that. Derek just smiled. _

_"I woke up early and I felt the need to surprise you." Meredith's stomach suddenly rumbled loudly and both Derek and Meredith stopped what they were doing. "Apparently, there is someone who's really hungry …" Derek said. "… and probably starving." Meredith added. "So, here's food. Yay …" There were also a lot of healthy things, green things on the tray. "Derek?" Meredith asked questioningly. "Why is there so much of those green things?" Derek looked at Meredith in confusion, not quite getting what she wanted from or what she meant with 'green things'. Then it occurred to him that she meant the vegetables. "Uh, what did you ask me?" Derek asked. _

_"Now I am confused. What's 'green things'?" Meredith pointed at one of the green paprika laying around there, cut in little pieces, ready to get eaten by a hungry human being. _

_"That's vegetables, Mer." Derek said, holding back a laugher. _

_"It's heart-healthy food and I figured it would be good for you. You know with the whole 'keeping your strength up'-thing." Derek carefully avoided any other topic like Meredith transferring hence the fact that it was a very sensitive topic to all of them. And it will be heated. But he also knew that he and Meredith couldn't avoid this forever. Somebody has to do the first step. It hurt that Meredith wanted to move. He cared about that. _

_He can't let his love slip away like this. They haven't continued their conversation about it, the conversation where Derek confronted Meredith, aka yesterday. _

_"Oh, that's right, vegetables. I think I am going to stick to the scrambled eggs and toast. But thanks for the offer." Meredith declined. Derek chuckled. He knew that was what Meredith was going to say. "Just eat, it's delicious and it's healthy, you'll like it." Derek tried to get her to eat those vegetables. He picked up a piece off and followed her with that until Meredith finally caved and ate it. He liked her face expression when she chewed on a piece of paprika._

_"So I have been thinking about the night where we are supposed to be studying for the intern exam …" Meredith said as she took a bite of her bread, chewing. Derek turned his head to her, watching her. "And what are you thinking exactly?" He asked. Meredith looked away. She knew Derek wouldn't like this at all. _

_"Oh come on Mer, just tell me whatever it is." _

_Derek did give persuading Meredith a try. Meredith looked at him for a short moment before saying. "You probably won't like this but I will do this, Derek. My decision is made. I am not like her." Derek scrunched his nose and put down his muesli bowl. Now Meredith had his undivided attention. _

_"Just tell me whatever it is, straight out, okay? I'm getting a little worried here." _

_Meredith looked at him, their breakfast was partly forgotten. _

_"I decided to let Stevens take part in our study group." Derek looked at her, completely baffled. He didn't really expect that from her. _

_Then he exclaimed loudly: "You did what?" _

_"She won't make it without help and she needs to realize that. We've been friends when we started and maybe the Izzie I knew is still there somewhere. She just needs to realize that I'm not the enemy. I am just the **competition** is all I am to her. So I am going to help her study so that she can pass." _

_Derek's ice-blue eyes were looking at Meredith intensively and inquisitively._

_"She … Meredith … I don't like the sound of this at all. I don't have a very good feeling about this. I mean she pushed you to the point where you thought it would be better to leave Seattle for good and start over in another city, at another hospital. You are thinking about transferring your residency because of what happened. You almost died because of her actions. Or did you forget what happened in the observation room where she made you take a run for it? You almost died, Mer. And now you're thinking about moving … I don't like this. Why don't I get to have a say in this, Mer?" Derek asked, the last sentence added softly. _

_Meredith swallowed hardly. _

_She didn't know what to reply. She knew Derek would not take this easy. _

_"You get a say in this, Derek. I am telling you now and this whole isn't until tomorrow." Meredith reasoned. _

_"You said, quote unquote 'My decision is made'. That sounds pretty final to me, doesn't it?" Derek stood up. He now paced through their bedroom. Meredith's eyes followed him. "I didn't forget about it, Derek. But I don't believe in payback. That'll get me fired. It's not a good option. Also, it's always called 'Keep her friends close and your enemies closer'. I repeat, she's just the competition." _

_"A pretty lousy competition, don't you think?" Derek asked back. _

_He knew Stevens was heading toward failing the test since he was an attending. "You can't say that. Not everyone is having a top-notch neurosurgeon by their side. You can't say that." Meredith frowned. Derek huffed. _

_"I know you don't like it. But why are we even arguing about it?" Meredith asked. _

_She didn't really have an idea where this was going. Derek looked at her for a second. "I don't want you to move to another state. I don't want to have to get on a plane to see my wife. I want to work with you, I want to teach you. I want you to aspire to greatness. All that, I want for you, do you get that? But you want to move and I have no idea when or where …" Derek knew life can change in a dime. _

_He was aware of that, sadly. _

_He'd been in so many situations like this. _

_"I don't know if I want to move, Derek. Everything is on the table. I know I have options." "I know about your options, Mer. This is why we are here in the first place. I don't want to move. Mark is here, my job is here. You are here. My life is here now. It's not on the East Coast or any other US state for that matter." _

_"Can we talk about this when it's real, Derek?" _

_"No. I suggest we do now because it is scarily real now." Derek hissed dejectedly._

_"Because …! As far as I know, this is just possibility of what can happen." Meredith replied. "If this doesn't work out for me, I have options. It might not be ideal but so it in life. Life never works out the way it's supposed to and you know that." _

_"A possibility? It's just a possibility? That's a relief, Meredith. It really is." Derek scoffed. _

_"Why are we even arguing about this?" Meredith called out in defense. _

_"We're about to get married, Mer. Married people live together, in a house or something. They don't live in different states except maybe when they're about to get divorced and hate each other's guts – you sure know I am not talking about us." _

_"Well, you're talking about yourself and Addison." That was a statement. "When will you know?" Derek asked quietly. "They're waiting for me to pass my intern exam." Derek smiled. _

_"Well, I know who will rank first." _

_"You're kidding, right? I'll never be number one." Meredith said, chuckling. _

_"My best friend's Cristina Yang and she's the one who will rank first for sure." Meredith added. _

_"How do you know? You didn't write the test yet." Meredith got out of bed and put some clothes on. "Wait, where ya going?" Derek asked attentively as he followed Meredith down the staircase. _

_Meredith walked into the kitchen, filled a cup with coffee. "What are you doing?" Meredith looked at him. "I am going in, what else am I supposed to do?" Derek laughed. Meredith frowned. She knew something was going off. "You're not going in, Meredith. Bailey has given you the day off." "Oh, crap." Meredith exclaimed. "I totally forgot that. I am going in anyway." The neurosurgeon gasped in utter surprise at Meredith's insistence. "Meredith, you've been working for over 48 hours uninterrupted. You need this day. You need it." Derek tried to persuade her. Meredith sighed and stopped. _

_"You're right, Derek. I need this day. I can't remember the last time I have been this tired and stressed out. You know this feud between me and Izzie … she ordered me around like if she was my boss, Derek. Even if she was just my fellow intern she gave me orders, telling me that I should do her charts. Apparently, Bailey wanted her to redo them because they were sloppy. There was another resident or intern named Dr. Myers as her accomplice. You know her?" Derek's eyes went wide in fear. He knew the name. He never worked with her and he was grateful for that. _

_"All I know is that she's trouble, Meredith." He cleared his throat, intently staring her down with his blue eyes. _

_"She's trouble?" Meredith frowned. Why did Derek say that? She needed more information on that resident or if she was a resident. _

_"She a resident?" She asked. Derek nodded. "But she's not one of the good ones, not like Bailey or Torres. She's the resident version of Stevens. Just don't get in her way, Meredith. Stay away from her, I am begging you." _

_"Whatever." Meredith sighed. "I'll stay away from her." _

_"Good that we agree for once." Part of him was mocking her when he said that. _

_Meredith looked away for a moment. _

_She didn't know Derek and Burke were fighting over the Chief's position hence the fact that he thought about resigning from being the Chief but not a surgeon. She swallowed before looking back at him. Derek noticed the mood change almost instantly after he got a view of her face. "What is it?" "When were you gonna tell me that you got the Chief's job offered? You and Burke have a little competition thing going on as well, ain't you?" She asked. Derek nodded resignedly. _

_"Yes, I …" "You were supposed to tell me that." Meredith cut him off. _

_"I know I should have told you after Richard told me that he was thinking about stepping back." Derek knew what he had done wrong. _

_Meredith added something. "And since our secret is out it's gonna be lot more difficult for me at work." Meredith added acidly. Derek tilted his head. She did this thing with her hands she always did when she was nervous and right now she was nervous. This whole thing was getting to her. If Izzie found out that she will get married to the head of neurosurgery she'll probably sabotage something or do something incredibly stupid. _

_Meredith didn't want her to know that she was getting married to Derek and now she knew. Meredith knew that Izzie knew. And she also feared that this will be part of something a lot bigger._

* * *

_Meredith was a very loyal person. At the end of the day she was waiting for Izzie to tell her about the interns' learning days before the big test so they could study. It wasn't fair to exclude Izzie when she knows she probably going to fail if there is no miracle happening. But right now she was waiting for someone to show up but apparently, this someone was too busy making new friends with some resident Meredith never knew about. "Why are you offering this?" Izzie asked, positively surprised. She hadn't expected Meredith to be so loyal after all she's done to her. _

_"If I were you …" But before Izzie could go on, Meredith cut her off. "But you are not, luckily for you." Meredith interjected with an eye roll. _

_"If I was you, I wouldn't have looked at myself ever again, not even to mention this. This is generous, really." Meredith ignored the ironic undertone in Izzie's voice, telling herself once again she can do this. Be the better guy or more, girl – or whatever. _

_Meredith gawked at her for a moment before saying: "Well, you still have a lot to learn. Izzie, if you want to pass it you need to this." Meredith said nothing but the truth. Izzie scowled. "I sure do but so do you." Meredith didn't reply really. _

_"Fine, I will come." Izzie finally agreed. _

_But there was no word on what happened the day before that, Meredith registered._

* * *

_ "Grey is getting married?" Izzie scoffed. Not only was she being favored she also was going to marry a top-notch neurosurgeon. She's got their respect without having to prove anything. This was so unfair. Meredith Grey didn't know how good she's had it. _

_She never had any money problems nor did she go to state school for college and university. Instead, she went to a private school. Those heart problems have triggered this. Before this, it was Meredith's relationship with her boss and now it's her medical history and not to forget, Ellis Grey, a surgical legend is Meredith's mother. _

_Izzie thought she'd every right to be jealous of the perfect little life Meredith had. _

_"Oh my God, of course she is. She's got lucky with this. But at some point, he'll probably leave anyway or she'll get her heart broken by him." Alex couldn't listen to her anymore. How did Izzie find out anyway? This is exactly why Meredith wanted to keep her and Derek's wedding plans hidden. She didn't want to jeopardize anything._

* * *

"Okay, fine." Meredith finally caved. Derek looked up from the medical journal he was reading. He scooted nearer to Meredith. "We can talk about it." Meredith said, followed by a loud sigh. "Hey, you know I love you. But this can't go on forever …" Derek's blue eyes were looking at her. "Yeah, I know that." Meredith said back. "So, you wanted to talk …" The young doctor said tentatively, tapping with her feet against the ground. Derek knew that Meredith was nervous. He knew her. "Well, you said you wanted to spend your day with me and me alone. So let's do that. Or does anything concerning …" He paused. "… your transfer requiring hurry up with something?"

"Well, at some point I have to contact them and tell them what I've decided but for now, we don't need to hurry anything." Meredith smiled at Derek for a moment and he replied with a soft kiss.

"No need to hurry. So that's good." Meredith nodded.

"That's indeed good." She agreed with him for once. "Are you hungry?" Derek asked. After seeing Meredith nod, he got up to his feet and walked down the stairs. Meredith frowned. She'd forgotten to go grocery-shopping. And Derek would know it as soon as he opens the fridge. She closed her eyes and counted to twenty.

At sixteen seconds she heard a call from downstairs.

He'd discovered the empty fridge with absolutely no food in it. There was no food to cook a decent meal. "Meredith. We have a problem. There is no food in the fridge." "It's not stocked. I forgot to buy groceries." Meredith called down in reply. Derek called back, loudly: "Are you coming? We're gonna go to the supermarket, now." Meredith only huffed before hurrying down the stairs where Derek was already waiting for her to get here. "Do we really have to this today? I mean we could order takeaway food. I'd like Chinese."

Meredith looked at him and tried to be convincing but not a chance. "No way. We're not ordering any food, Mer." Derek declined her offer.

Derek made his mind up about wanting to spend a romantic evening with his soon to be wife. But before that's going to happen, they need groceries. "Yes, Meredith, we're doing this. We have the house for us, only for us and I am going to cook since you obviously can't." "Well, you could always teach me, Derek." Meredith smiled at him, seducing.

A sparkle appeared in Derek's eyes and before he knew Meredith and he were kissing. But then he softly broke it, seconds before saying: "We need to get the groceries. Otherwise there won't be any dinner to eat." Meredith laughed, and it was a sound Derek couldn't hear enough. When she is happy he's happy. So they both got into the car and they stopped at the nearest supermarket.

First, they went to the vegetable section of the supermarket where Derek stuffed all kinds of vegetables into the shopping cart.

Meredith watched him doing that, wondering secretly what he wanted to do with this stuff.

* * *

When Meredith turned around she saw a familiar looking figure coming her way. She immediately knew that it was her half-sister. "Damn it, what's she doing here?" Meredith muttered under a breath. Hasn't she someplace else to be? Apparently not otherwise she wouldn't be here. Lexie hasn't seen Meredith and Meredith used that to her advantage and disappeared into of the aisles, she was now officially hiding between the cat food and other stuff that they keep here. She knew it was creepy and weird that she was hiding just because her half-sister was in the same building as her.

But somehow, Lexie has gotten view of Derek who was still quite visible. So she knew that Meredith must be around somewhere as well. And at some point, she found Meredith. She needed a product that was in the exact same aisle as Meredith. At first, Lexie didn't see Meredith standing there because she was heading straight for what she wanted. Only after she looked up, she saw her half-sister standing there, obviously wanting to avoid her.

Lexie could understand why Meredith would want to hide and she wanted to give her the time she needed to accept that she had siblings but they were running out of time. Soon, Lexie Grey would be on the way to another state to begin her surgical residency.

She'd be in Boston, on the East Coast.

She just wanted a chance to get to know her sister a little better. That's all she wanted. Lexie just wanted Meredith to give her one little shot of getting to know her. It wouldn't be easy.

But she would try and not give up.

"Meredith?" Lexie asked and hoped she would turn around and not run as soon as she saw her, her heartbeat accelerating a bit by knowing that she was more than likely to receive a not so different answer like she did last time.

But this time, Meredith surprised her by not cutting her out completely.

"Lexie Grey. Ain't that right?" Meredith got up, obviously caught by surprise. "What are you doing here, Lexie?" She asked overwhelmed and feeling the need to just drop everything and run. But she stopped because at some point she has to do something to get to know this girl. Apparently, the two of them are related.

That brunette girl was her biological sister or half-sister.

"Grocery shopping – which seems pretty obvious, doesn't it? My father wanted me to stock up the fridge." Lexie laughed nervously. "Look, I know you think I am some weird psycho who keeps tracking you down and following you but I am not. All I want is a chance for us to get to know each other."

Meredith avoided her view for a moment before answering. She couldn't decide what she should answer. Life ain't easy for her and for anyone. "Look, I can sense that you are just being sincere but if this is your way of trying to fix your father's mistakes … don't do it. I don't want anything to do with him." "… Or his family – is that what you're trying to say." Lexie sighed. She'd hoped Meredith would come around this time but it seems like her hope was going to be crushed once again by her older sister that didn't want to get to know her. Meredith shook her head in reply.

Lexie deserved to have a chance and by giving her that chance she opened her heart to let her sister in. It would take time, yes but remember what they say about time: Time heals wounds. Now it's time to try it out. Meredith made that decision in a split second. Derek would be proud of her.

"No, Lexie, I can call you that, right?" Meredith asked. Lexie nodded. "Sure you can." _You're family, my sister_, she silently added.

"I was talking about him. I don't want to have to meet Thatcher Grey."

"Let me guess, last time didn't go so well? Well, that's to be expected after abandoning his daughter." Lexie replied.

"How'd you know?" Meredith asked confused.

"He wasn't very happy afterwards. Look, when I found out I was angry with him, really angry and hurt. I have told him 'I could have grown up with a big sister and you running took that away from me'. I didn't talk with him for days and honestly, I am still pissed about how this could have happened. So this is not about me wanting to bribe you into forgiving him or whatever." Meredith looked at her half-sister, trying to decide whether she was lying or if she was telling the truth. But after a look into her hazelnut-brown eyes, she knew she was telling the truth. Meredith nodded.

"Okay …" The surgical intern slowly said, not taking her eyes off Lexie.

"How about we arrange something before you leave for your internship at Mass Gen?" Lexie coughed in surprise. She'd certainly not expected this to happen. This was too good to be true. Then she saw that Meredith was smiling at her. It was a happy and relieved smile. Meredith was glad to have made this first step.

The first step is always the hardest and she did it.

"Hey, breathe." She said when she noticed Lexie's absolute perplexed face expression at her suggestion. "I am breathing and I would love to arrange something like this. I'm leaving in a week so that means there is enough time for us to schedule something. Maybe we could go to a café and talk." Lexie suggested when she got her voice back. "That sounds good. Ahem, maybe we should exchange phone numbers to keep in touch and addresses." Meredith stated, fumbling with her cell phone to save Lexie's contact data.

"Okay, then." For a few awkward seconds they were standing there and looked at each other. "Bye." Lexie stuttered before leaving.

"Bye." Meredith answered.

After they had exchanged addresses, they both went their way.

Meredith couldn't help but thinking that this had been a good decision. Derek was waiting anxiously for Meredith. He couldn't shake the feeling that she might be in danger. He hasn't seen her and he's been searching the supermarket when a person he somewhat knew appeared.

* * *

Soon, he'd identified her as Lexie Grey, Meredith's half-sister. Instantaneously, he knew what must have held her up. This was it. Lexie was smiling happily, like she'd won a big prize. Derek reached her. "Ms. Grey?" He asked. "Have you seen Meredith Grey, your half-sister, here somewhere?" Lexie scanned him shortly before turning around and pointing toward the direction Meredith was headed. "She's looking for you too." Lexie said. "Thanks for your help, I really appreciate it." Derek smiled at her shortly before gripping his shopping cart tightly and walking toward Mer's suspected location. He didn't know Meredith was hiding in one of aisles. "I'm here." She suddenly stepped out of hiding. A smile formed on his face. "There you are." He pulled her into his arms.

"Not in public, Derek." Meredith reminded him. "So care to tell me where you were all the time?" "It's secret." Meredith said. "It's not, come on."

"I'll tell you after dinner." Meredith finally agreed. "Now that we've sorted that out, can we go home?" Derek asked after he placed a kiss on Meredith's lips. "Yeah, you said you wanted to cook dinner. So it's better if we go home because I am starving." Meredith chuckled. "Then let's go." Derek said as he pushed the cart. Soon they were standing outside the building, putting their food into Meredith's car that was parked in the parking lot. It was pretty warm outside and they both felt it.

"So how long do you think cooking dinner will take?" Meredith asked, she showed with that she had absolutely no idea about cooking – none, absolutely none.

Twenty minutes later, Derek was standing in the kitchen, between a lot of vegetables and other things you need to cook a decent meal.

Meredith watched him attentively.

He really seemed to know what he was doing. She could see that. Everyone with half a brain could see that. "Do you want me to help you with something?" Meredith asked. Derek looked up and smiled at her dreamily, with a happy, reassuring smile that was telling that he has got it under control. "No, I've got it, Mere." He replied. "You're scared that I will set the kitchen on fire." Meredith stated, chuckling. "No, I am not. Okay, maybe a little bit." Derek agreed. "See, I am right again. I am not allowed in my own kitchen." Meredith laughed. She didn't mind at all.

"You're allowed in your own kitchen." Derek replied chuckling, while cutting vegetables into little pieces. "That's where I disagree." Meredith countered as she came nearer. Soon, Derek felt her putting her arms around him. "You're right, I can't cook. I'll probably set the kitchen on fire with my luck."

"Maybe I can teach you." The neurosurgeon said. Meredith kissed his neck. Derek smiled happily and put whatever he holding in his hand, down.

"I'm a hopeless case. I doubt that it will do anything good. However, thank you for offering." Meredith replied. "Oh come on, there is no way a human being can only eat pizza for breakfast and so on. At some point you want to eat something different. And just for the record you're not a hopeless case."

"I can always order Chinese or something." Meredith shrugged.

"Chinese for breakfast … Really, Meredith…? Clearly you aren't thinking." Derek asked in shock. "Now I really think I have to teach you how to cook your own meal." "Are you sure that this is a good idea?" Meredith asked mockingly. "Last time, I tried to cook something, it went south. You could that. I and the kitchen just don't go so well." Meredith tried to tell him. Another hour went by as they waited for the dinner to get ready. "Derek, when's the food ready?" Meredith asked him with big eyes.

"Are you hungry?" He asked, his blue eyes sparkling at her.

"Of course I am hungry, Derek." Meredith answered. "Just be patient, it won't be so long until it's ready." "But I'm starving, Derek. You said that like hours ago." He shushed her with kissing her softly.

At some point, dinner was ready and they were able to start eating. Soon after that, Meredith said: "Who could have thought these vegetables could be so delicious. You're a good cook." That's when Derek started laughing.

Soon, Meredith joined him. After they calmed down, they went back to eating.

"So will you tell me why you suddenly disappeared?" Derek asked as he set his wine glass back on the table. It was just him and Meredith and their food, some dimly lit candles. It was romantic.

"I will tell you." Meredith cleared her throat.

"I met Lexie. We've …"

"You met Lexie in the supermarket, do I understand this correctly? It's what I think since I've met her there." Derek asked.

"And you've …" He waited for Meredith to complete that sentence. "We've kind of bonded. I know this doesn't happen overnight but we might get somewhere. We exchanged contact data. I didn't run, Derek. Isn't that great? Everyone says I run but now I didn't run." Meredith and Derek were both as equally happy.

"I didn't run-"

"That's great news, Meredith. I'm proud of you. You know that right?" Derek smiled at her dreamily, his fingers tracing over her cheek.

"I love you." Meredith said and leaned over to him. Their lips met and they kissed with eyes closed. It was just them and nobody else. Just perfect. Soon they disappeared upstairs and the door to their bedroom shut soon after that. The dishes would have to wait until tomorrow.

But way to soon this day ended, just like any other day and Meredith and Derek had to get up and get ready for work. But Meredith didn't want to get up. Derek was already up and has prepared breakfast for the two of them, only to discover that Meredith was still in bed. So he decided to wake her up so that she wouldn't be late.

He walked up the stairs, quietly of course.

Then he entered his and Meredith's bedroom. He sat down on the edge of the bed. He saw Meredith's small figure under the covers. Derek Shepherd put his hand on Meredith's shoulder and shook it softly, in the hope that this would wake her up.

"Meredith." He whispered but apparently, Meredith was still asleep hence the fact that there was no reaction coming her besides soft snores. "Meredith, come wake up. You've got to go to work, sweetie." He reiterated.

"Let me sleep." Meredith grumbled into her pillow.

"Get up, Meredith. Bailey won't like it if you're late."

Meredith huffed but never said anything coherent. "C'mon, rise and shine, Mer. Get up." Derek said, tracing the fingers over the sheets where Meredith was. Her head disappeared under the covers.

"I'm not working." She said her voice muffled 'cause her head was still under the covers.

"Well, you are." Derek countered. "My shift starts in three hours." Meredith mumbled almost inaudibly. Derek looked at the clock radio. "No, actually it starts in thirty minutes. Meaning, you have ten minutes to shower etc. max. So you might wanna hurry." He advised her. Meredith slowly sat up and she looked at him tiredly. "Who cares? They hate me enough already so why don't add 'being late for rounds' to the list, hm?" "Who is 'they'?" Derek asked, immediately concerned about his soon to be wife. "You really have to ask, Derek?" Meredith snapped.

"Hey, Mer, I know right now it's not easy for you at work but that'll change. I promise. Just get up and get yourself ready for work, Mer." Derek tried to negotiate.

"Fine, I'll get up."

Meredith met Cristina in the locker room. "Morning, Mer." Cristina said happily at the prospect of working on a cardio patient. "Hey, Cristina …" Meredith mumbled as she sat down on one of the benches in the locker room. In this moment, the others entered the room as well. Alex greeted shortly but the others stayed silent. Meredith's thoughts went back to today's plans. Today they were gonna to the Transcatheter Aortic Valve Implantation on their patient. Meredith had been looking forward to that because it was interesting. Maybe this could have saved her the risks of an open procedure. Dr. Bailey was entering the locker room soon after Meredith. She had her usual scowling face expression.

"There's been a change of plans. All the other attendings have something else to do, it's all I am saying." She started her introductions. "You'll all be working in the pit with the exception of Grey and Yang who are the assisting interns on the case of Burke's TAVI patient."

"Well, of course it's Yang and Grey. Who else should it be?" Izzie huffed. Bailey's view shot to Izzie Stevens.

"You, be quiet." She said quietly and immediately, Izzie fell silent. Meredith silently wondered how Bailey did it. Then the resident sent the interns their way after telling them to not forget to study for the intern test.

* * *

Dr. Bailey paced in front of the Chief's office. She knew she needed to inform Webber of what happened that night. When she had worked up enough courage to knock on the Chief's door, Callie Torres approached her. When she saw what Bailey did she immediately knew that this was about one specific night shift. "Dr. Bailey." She called over to her. Bailey turned around when she heard Callie Torres' voice. "You have requested a meeting with the Chief about what happened that night, aren't you." "Yes, and you've interrupted it. I was about to knock on his door. Well, if you need anything, page me. I have a case anyways, so …" With that she turned around. Bailey watched the retreating back of Callie before she knocked and this time no one interrupted her.

Then Bailey opened the door without waiting for his reply so it comes that Webber was quite, let's say surprised, when he saw Bailey entering his office out of the blue.

"Dr. Bailey, what are you …" He got up from his chair and walked over to her. "What brings you here; Dr. Bailey. As far as I know is that you have got a surgery scheduled in a few minutes, which brings me to the question: What are you doing here when you should be scrubbing in by now?"

"I need to talk to you about a nightshift that took place not so long ago."

Dr. Webber's brown eyes were focused on her.

"Let me guess, this is about Stevens and Grey? Are they still on each other's throats?" Bailey huffed.

"It's more like Grey does all of the ongoing grunt work, while the others are doing things that weren't quite related to medicine. I am very content with her work. She did a good job coordinating between the floor, the ER and her patients. But that still doesn't change the fact that she covered the pit which I believe was Stevens' job at that point. Although there is no single record of her ever doing so … And then there was this thing Karev may or may have not mentioned. Rumor has it that this fight between Grey and Stevens is due to Grey's medical history which is completely unacceptable."

Dr. Webber put his hands on the table as he faced his colleague.

"Did she file a complaint I don't know about or what is this about? We don't go easy on interns, Bailey."

Bailey scowled before saying: "Believe me I know exactly what this means." "Oh do you? Is that why you think you can come to me over nothing?" Now the Chief and Bailey were looking each other in the eye.

"It's not over nothing." Bailey said very quietly.

"That girl was working for over 48 hours, straight, Dr. Webber. She did everything what anybody told her to do. She covered pit, floor and OR at the same time. Now tell it's over nothing. Tell me." Eventually Webber caved, and gave in to the pressure.

"But instead of doing it, she somehow tricked Grey into doing it."

Dr. Miranda Bailey told him the story from her point of view.

She knew O'Malley and Stevens would get their chance to explain what the hell went down that night and how it happened and of course, why it happened. "Dr. Grey's work has been exemplary and she does quite a good job when coordinating among the OR, the floor and the pit." Dr. Webber glanced at his general surgeon, clearing his throat. "Chief, don't you want to do something? They are soon residents which means they are gonna be responsible for their patients living or dying."

"Which begs the question who the hell are you talking about? Can you give me names? I want names. I can't condone this kind of behavior. I want those kids to play nicely together in our sandbox." Dr. Bailey let out a chuckle. She didn't mean to be disrespectful but the sentence was just so funny.

It wasn't possible not to laugh at some point.

"In our sandbox, Chief, really … Don't you have a better metaphor than this? You compare a high-functioning hospital to a sandbox?"

Bailey's laughter slowly died down.

"Don't you dare laughing about this situation … That's nothing to laugh about and you know it. I want this fixed and I want it fixed yesterday." Dr. Webber ranted. He couldn't believe what was happening on his surgical floor. This kind of behavior wasn't happening under his radar. In this moment, there was knock on the door.

"Come in." Dr. Webber called out, distinctly he was hoping whatever the issue was it wouldn't take long to take care of it.

But he was wrong. The door to his office opened and Derek Shepherd, his word-class neurosurgeon entered the room. But Richard knew by the look of his face that his visit had more to it than just coming by.

This meant more.

Once again, his instincts proved to be correct. Derek was in fact here because there was something he needed something that was indeed very important to him. "Derek." Dr. Webber exclaimed surprised. Derek was surprised as well when he saw Bailey there as well. "Is there anything I can do for you, or help you with?" He asked smiling although his mind was occupied with the things Bailey talked to him about.

"There is. There is something I feel you should know." Then he stopped. "What are you talking about, Shepherd?" Bailey was quick to answer. She was currently staring him down. And the point was that it actually worked. "I was just talking to Dr. Webber about the working situation here because, as you might know, we got a situation." "A situation is what you call this, folks?" Derek faked a laugh.

"You've got that kind of situation since Stevens' and Grey's blood feud started after Grey started working again but since all of you have closed your eyes and decided not to do anything about it … it got out of control." Derek saw that both Dr. Bailey and Dr. Webber have been all ear and they were listening to him. Meredith wouldn't approve this if she knew. She wanted to manage the situation on her own but look were it got her. Derek wouldn't go with this any longer.

This has been going on way to long for his liking. It ends now.

"Go on." The Chief told him. Derek did.

"Alex Karev is saying that she's doing it because she couldn't get over the fact that Meredith hasn't told them about her congenital heart defect. That's what this is about."

"That's totally unreasonable." Derek shrieked.

He couldn't believe this.

But then he remembered the surgery he did together with Meredith not too long ago. It was an aneurysm. Every intern, Cristina and Meredith left out, was sitting in the observation gallery and the intercom was on so he and Meredith heard every little thing they said or not said. Only Karev finally spoke up and put an end to it when he was called away on duty. It was when Stevens was trash-talking Meredith.

He would never forget the look painted on Meredith's face even when she was trying to hide it, to cover it up but he knew how to read her even when she only shows minimal reactions to something.

He knew for a fact that that must have heard her.

"So if I understand this correctly, you are saying that Stevens is doing this because of Grey's medical history?" "Yeah, Meredith said it herself but she didn't wanna involve you …" He nodded toward Webber and then toward Bailey.

"… and you … She wanted to deal with the situation on her own. Meredith doesn't want to be a burden to anyone."

Derek looked at them.

His superior cleared his throat while Bailey was staring him down or trying to stare him down.

They have fallen silent, not exactly knowing what to reply.

This was all to shocking to reply.

"And there's something else. Meredith is thinking about leaving Seattle Grace. If she knew I was telling you this she would for sure kill me but I think you should know and maybe put a stop to this before it gets totally out of control.

* * *

Meredith and her fellow students were once again occupying Meredith's house, in order to study for the intern exam. The test was supposed to be tomorrow. Derek woke up really early, his pager woke him up. Someone was paging him for a consult. Derek slowly woke up and opened his eyes "Morning. What is everyone doing here so early?" He asked. "Don't you guys ever sleep?" Derek asked as he lets his tired gaze flow through the room. "Hi, Dr. Shepherd. We're just studying for the intern exam." Iz smiled perkily at the neurosurgeon. Meredith jumped up from her chair as she saw her fiancé. She embraced him. "You're leaving early. Are you going to the hospital?" Meredith asked as she looked up to him. "Yeah, Richard paged me to take a look at a head trauma." He explained before planting a kiss on her hair, Cristina shortly looked up and huffed when she saw her person and Derek interacting. Yang rustled through the flashcards, suddenly feeling the need to bombard Derek with neurosurgical questions. He might as well put his knowledge to good use. "Wait." She kissed him softly on the lips as if they were doing it every day. "Shepherd, wait. Treatment of an aneurysm: you can repair an aneurysm by clipping the base of the aneurysm." Cristina asked.

"Right, Yang. Will you let me go to work now?" She got as a reply. But Cristina didn't make any moves that indicate so.

Instead, she kept on asking him questions about a medical procedure.

"Then you do something called a matador move to test whether the aneurysm is clipped. If it's not clipped right it's gonna burst." Meredith added. "I understand you all want to learn and so on but I kind of really have to get to work. Maybe I can test you all later if that's possible? Then I can help you study. With the neuro part at least." Derek looked into the interns' faces and they nodded in approval.

"Fine." Cristina leaned back in her chair and rubbed her eyes for moment. Derek used that moment to escape. Anyhow, the study palooza went on. They formed teams. Meredith and Cristina were team #1 and Alex, George and Izzie were team #2 but George wasn't here. Meredith and Cristina had won, definitely. So much was clear. Meredith was pretty fast in spouting of answers. She had the brain to achieve brilliant things as did Cristina. They would both make extraordinary surgeons. Meredith was thinking about a residency she will be spending in neuro for the most time. That would be great. She hasn't talked to Derek about that yet. Maybe she should, though. He's her husband in a few weeks.

"Why is a _tension pneumothorax_ more dangerous than a simple pneumothorax?" Meredith asked a question for Cristina who racked her brain for like three seconds before screeching the answer.

"When a damaged lung, damage can be due to rib fractures, leaks air into the chest cavity and the lung will collapse as the chest cavity fills with air. When the air becomes pressurized, the air gets into the thorax but not out like when it's a simple pneumothorax is and with that it presses heart, lungs, trachea and pleura aside which leads to difficulty breathing, no breathing sounds and tracheal deviation. Immediate treatment is necessary to prevent cardiac arrest."

Izzie huffed contemptuously.

Both women condoned her somewhat callous behavior, it seemed best to ignore it.

"Great. Now it's my turn. Quiz me. But I am good. Derek trained me."

"Private lessons with the head of neuro – I want to have it that difficult." Cristina said ironically.

Meredith ignored her friend's comment. "Okay, here you go. What's a _complicated bone fracture_?" Cristina has picked an orthopedic question for Meredith.

"The fracture's complicated by injuries to joints, blood vessels or there is nerve damage or damage to other tissues or organs." Meredith answered. "That was too easy. Hit me with a hard one." She told them, smiling.

"You want a hard one?" Cristina smiled, mischief written on her face.

"There you go. What's a _car park collapse_?" She fired a hard one at Meredith who sat straight on her chair. "You have ninety seconds. Go." Cristina Yang cheered on her friend. "You think she can do this?" „Why are you asking that kind of question? I mean, is that even medical related?" Izzie asked with confusion covering her face.

"Yes." Meredith and Cristina said in synchrony.

Meredith had heard Derek refereeing about near-drowning.

He'd mentioned something about 'car park collapse'. Then she had it together. "A 'car park collapse' is what can happen after a near-drowning event, especially if there was loss of consciousness at some point. The patient's status will be unstable a few hours afterwards which means they should be monitored for at least 24 hours before allowing them to walk. Letting the patient do this too soon could result in collapse or death." Cristina stared at her in fascination.

"Wow. You're good." Cristina said. "Should I ask another one?" "Go for it." Meredith shrugged only. She could answer these questions.

* * *

"So, has anyone an idea why you're here today?" Richard asked as his view slid over his summoned people, those who were in charge, meaning the attendings were at this staff meeting as well Dr. Richard Webber wanted to put a stop to this. He'd condoned the outspoken and disrespectful behavior of Stevens long enough and he wouldn't go with it any longer. Derek had spoken with him. And he was shocked when he heard what Grey was planning to do or thinking of doing.

"Why are we here anyway?" Stevens didn't like being called to the Chief's office.

It was like she was back in school when she was called to the principle. This was like being called to the principle, only ten times worse. Cristina scoffed before continuing scornfully. She still couldn't believe or think of any valid reasons of why they had waited so long before doing something about it.

None of it is fair towards Mer.

They've been responsible and they have let this happen. They've waited too long before finally responding. "This is why we're here? Just because some incompetent first year wants to quit the program are we here? It doesn't matter anyway."

"It should matter, Stevens and it does. How dare you criticize a fellow surgeon when your own competency should be called into question?" Dr. Bailey interjected, her eyes sending daggers at the blonde surgeon.

* * *

**A/N: Ok, this chapter mostly contained a flashback but it's a flashback from importance. They haven't really talked about the possibility of Meredith leaving Seattle Grace for good and continue her medical education at another hospital. At some point, Meredith and Derek will have to talk.**


	43. Chapter 43

**Chapter 43**

* * *

**The human body is a highly pressurized system. The blood pressure measures the force of blood, pulsating through the arteries. It's important to keep this pressure regulated. Low or inadequate pressure can cause weakness or failure. It's when the pressure gets too high... that problems really occur. If the pressure continues to increase, a closer examination is called for... Because it's the best indicator that something is going terribly wrong. Every pressurized system needs a relief valve. There has to be a way to reduce the stress, the tension, before it becomes too much to bear. There has to be a way to find relief, because if the pressure doesn't find a way out... it'll make one. It will explode. It's the pressure we put on ourselves... that's the hardest to bear. The pressure to be better than we are. The pressure to be better than we think we can be. It never ever lets up. It just builds and builds and builds.** Something's Gotta Give; Meredith Grey

* * *

"Dr. Burke." Meredith and Cristina were on their way to finding Burke now. Today was the day the TAVI should take place. "Well, today's we have a TAVI planned. Grey, I suppose you manage the pre-op care of this patient. I expect you to be fully focused. Prep the patient for surgery. Page me when you're done." Meredith nodded. "Sure thing, Dr. Burke, consider it done." Meredith answered as she heard the sound and vibrating of someone's pager. It turned out that it was Burke's pager. He glanced at it and then nodded. "Grey, I already told you what do. Go." He said. Meredith nodded before hurrying toward the cardio wing to prep their patient. The Chief had paged all of them to the Chief's office. "What? Why are we being paged to the Chief's office?" Burke asked no one in particular. Some nurses and orderlies rushed by, pushing carts with medical supplies on it. But he just turned to Cristina. "I come with you." She insisted. Burke looked at her flabbergasted. "No, you won't." Burke told her but Cristina wasn't exactly listening.

"I have a right to be there. This whole thing is about Meredith." Cristina exclaimed. "You know something." Burke said. That wasn't a question … it was more like a statement.

"Yeah, I think I know something. I think I know about what this meeting is." Cristina said.

She was glad that Chief was finally doing something, for Meredith's sake. "How so?" Burke asked, frowning as he studied Cristina. His girlfriend knew indeed something.

"I … can't say. It's not really mine to tell." Cristina avoided his question deliberately.

"Morning everyone." He looked around briefly before getting to it point. "So, has anyone an idea why you're here today?" Richard asked as his view slid over his summoned people, those who were in charge, meaning the attendings were at this staff meeting as well Dr. Richard Webber wanted to put a stop to this. He'd condoned the outspoken and disrespectful behavior of Stevens long enough and he wouldn't go with it any longer. Derek had spoken with him. And Dr. Richard Webber was shocked when he heard what Grey was planning to do or thinking of doing.

Dr. Burke was here as well even though he had a surgery planned in about an hour.

He had Meredith Grey doing the necessary pre-operative tests to confirm the patient is good to go. After giving this assignment to Meredith, Burke's pager beeped and signaled that he was paged to Chief's office, concerning one of their (soon to be -) residents. When he got that message, he sent Meredith on her way and she did – to his luck without asking many questions. Dr. Preston Burke was glad about that.

But Cristina, that was another story. While Meredith was totally oblivious to what's going on, Cristina demanded that he tells her about whatever's going on because she thinks she knows what this is about and when this is what she thinks it, then it does concern her.

"Stevens, the Chief requested you to come to his office now." Bailey said darkly. Izzie didn't look like she had an idea of what was going on. "Oh, come on, why? I mean, I haven't done anything so why …" "You haven't done anything?" Bailey reiterated sarcastically. "A lot of us seem to think different about this." Bailey only said, leaving Izzie to figure out what that meant. "Follow me. The Chief hasn't only requested you to meet us in his office he also told his department heads to clear their schedule to attend to this assembly." That's when Izzie Stevens finally fell silent. Soon, they reached the Chief's office. Izzie froze for a second when she saw all the staff that was pointing and staring at her and for the first time she felt how Meredith must have felt after the gossiping started. This is why she kept it a secret.

Izzie turned her head from the left to the right side, only recognize Alex Karev standing there, near the Chief's office, Cristina and Burke were there as well.

"Why are we here anyway?" Stevens didn't like being called to the Chief's office.

"You are here today because something not condonable has been brought to my attention and I am going to put a stop to those things I am talking about and be sure that there will be consequences. Whoever decided they could pull this little stunt and mistreat their fellow surgeons, be warned: there will be consequences, severe consequences."

"What for? I haven't done anything wrong."

That's where others disagreed.

It was like she was back in school when she was called to the principle.

This was like being called to the principle, only ten times worse. Cristina scoffed before continuing scornfully. She still couldn't believe or think of any valid reasons of why they had waited so long before doing something about it. None of it is fair towards Mer. What Izzie did to Meredith wasn't fair.

Meredith's relationship to Derek was legit – they were going to get married.

But apparently, Izzie's main problem was that Izzie Stevens thought Meredith was getting advantage out of the fact that she was born with a congenital heart defect which was utter crap but somehow, Stevens thinks Meredith is being favored because of this.

They've been responsible and they have let this happen. They've waited too long before finally responding. But now they finally were responding. That was all what mattered to Cristina, that they would finally do something. Because letting someone work for more than 72 hours straight isn't right. "This is why we're here? Just because some incompetent first year wants to quit the program are we here? It doesn't matter anyway." She complained so that everyone in this room heard her.

Cristina just looked at her, shocked how her fellow intern could be so cold-blooded. But before Cristina could respond in any way, Bailey already opened her mouth. Apparently, she'd been faster than Cristina.

"It should matter, Stevens and it does. How dare you criticize a fellow surgeon when your own competency should be called into question?" Dr. Bailey interjected, her eyes sending daggers at the blonde surgeon.

"Okay, then where is she?" Izzie asked loudly, her voice tripled in volume.

"Could you keep your voice down, Stevens? You know that you're speaking with your Chief of surgery of Seattle Grace Hospital which means I decide what happens in my hospital-" Izzie cut him off, apparently she didn't think about the upcoming consequences or she just didn't care at all.

"Where is she?" She repeated her question in a loud demanding voice.

"If she has a so called problem with me, why isn't she here to speak up? Or is she hiding somewhere? Avoiding because god knows that that's her way of dealing with things she doesn't like. She runs because she is scared to face whatever's bringing her down. She runs and avoids is what she does. She's an avoider, a coward." Izzie scoffed, feeling better after she let this off her chest. Cristina and her other colleagues threw shocked glances through the room.

"She runs. It's what she does best." She reiterated. Derek's blood boiled as he heard what Izzie just said. This was adding insult to injury. She will only make it worse by saying that, doesn't she get that? Apparently not.

_Unbelievable. _

This is unbelievable ...

For a moment, it was deathly quiet in this room.

Then Cristina Yang stepped forward, a wild expression on her face.

* * *

**A/N: Hey, there. There won't be any updates any time soon since I have to focus on school right now ... But I will continue this story at some point. Please review.**


	44. Chapter 44

**Chapter 44**

* * *

**A surgeon's education never ends. Every patient, every symptom, every operation ... is a test. A chance for us to demonstrate how much we know ... And how much more we have to learn ... **Meredith Grey; Testing 1-2-3

* * *

"Dr. Burke." Meredith and Cristina were on their way to finding Burke now. Today was the day the TAVI should take place. "Well, today's we have a TAVI planned. Grey, I suppose you manage the pre-op care of this patient. I expect you to be fully focused. Prep the patient for surgery. Page me when you're done." Meredith nodded. "Sure thing, Dr. Burke, consider it done." Meredith answered as she heard the sound and vibrating of someone's pager. It turned out that it was Burke's pager. He glanced at it and then nodded. "Grey, I already told you what do. Go." He said. Meredith nodded before hurrying toward the cardio wing to prep their patient. The Chief had paged all of them to the Chief's office. "What? Why are we being paged to the Chief's office?" Burke asked no one in particular. Some nurses and orderlies rushed by, pushing carts with medical supplies on it. But he just turned to Cristina. "I come with you." She insisted. Burke looked at her flabbergasted. "No, you won't." Burke told her but Cristina wasn't exactly listening. "I have a right to be there. This whole thing is about Meredith." Cristina exclaimed. "You know something." Burke said. That wasn't a question … it was more like a statement.

"Yeah, I think I know something. I think I know about what this meeting is." Cristina said. She was glad that Chief was finally doing something, for Meredith's sake. "How so?" Burke asked, frowning as he studied Cristina. His girlfriend knew indeed something and he saw it in her face.

"I can't say. It's not really mine to tell." Cristina avoided his question deliberately.

"Morning everyone." He looked around briefly before getting to it point.

"So, has anyone an idea why you're here today?"

Richard asked as his view slid over his summoned people, those who were in charge, meaning the attendings were at this staff meeting as well as the interns. Dr. Richard Webber wanted to put a stop to this. He'd condoned the outspoken and disrespectful behavior of Stevens long enough and he wouldn't go with it any longer. Derek had spoken with him. And Dr. Richard Webber was shocked when he heard what Grey was planning to do or thinking of doing. Dr. Burke was here as well even though he had a surgery planned in about an hour.

He had Meredith Grey doing the necessary pre-operative tests to confirm the patient is good to go.

After giving this assignment to Meredith, Burke's pager beeped and signaled that he was paged to Chief's office, concerning one of their (soon to be -) residents. When he got that message, he sent Meredith on her way and she did – to his luck without asking many questions. Dr. Preston Burke was glad about that. But Cristina, that was another story. While Meredith was totally oblivious to what's going on, Cristina demanded that he tells her about whatever's going on because she thinks she knows what this is about and when this is what she thinks it, then it does concern her.

"Stevens, the Chief requested you to come to his office now." Bailey said darkly.

Izzie didn't look like she had an idea of what was going on.

"Oh, come on, why? I mean, I haven't done anything so why …" She argued back, she still thought that she hasn't done anything.

"You haven't done anything?" Bailey reiterated sarcastically.

"A lot of us seem to think different about this." Bailey only said, leaving Izzie to figure out what that meant.

"Follow me. The Chief hasn't only requested you to meet us in his office he also told his department heads to clear their schedule to attend to this assembly." That's when Izzie Stevens finally fell silent. Soon, they reached the Chief's office. Izzie froze for a second when she saw all the staff that was pointing and staring at her and for the first time she felt how Meredith must have felt after the gossiping started. This is why she kept it a secret. Izzie turned her head from the left to the right side, only recognize Alex Karev standing there, near the Chief's office, Cristina and Burke were there as well. "Why are we here anyway?" Stevens didn't like being called to the Chief's office.

"You all are here today because something not condonable has been brought to my attention and I am going to put a stop to those things I am talking about and be sure that there will be consequences. We don't accept disrespect around here. We're a hospital, a hospital with sick people who are here to get better. And we're here to make that happen. Whoever decided they could pull this little stunt and mistreat their fellow surgeons …"

He paused, glancing at them in a meaningful way.

"Be warned! There will be consequences, severe consequences."

It was like she was back in school when she was called to the principle. This was like being called to the principle, only ten times worse. Cristina scoffed before continuing scornfully. She still couldn't believe or think of any valid reasons of why they had waited so long before doing something about it. None of it is fair towards Mer. What Izzie did to Meredith wasn't fair. Meredith's relationship to Derek was legit – they were going to get married.

But apparently, Izzie's main problem was that Izzie Stevens thought Meredith was getting advantage out of the fact that she was born with a congenital heart defect which was utter crap but somehow, Stevens thinks Meredith is being favored because of this. But Meredith wasn't getting advantage from anything. She is working hard and she's dark and twisty – that's why Cristina and Meredith are such good friends.

They've been responsible and they have let this happen.

They've waited too long before finally responding. But now they finally were responding. That was all what mattered to Cristina, that they would finally do something.

Because letting someone work for more than like, 72 hours straight isn't right. It's not fair.

It wouldn't be fair to anyone in the same position. Izzie scoffed. "This is why we're here? Just because some incompetent first year wants to quit the program are we here? It doesn't matter anyway." She complained so that everyone in this room heard her. Cristina just looked at her, shocked how her fellow intern could be so cold-blooded. But before Cristina could respond in any way, Bailey already opened her mouth. Apparently, she'd been faster than Cristina. Okay, now she was really adding insult to injury which only makes the situation worse than it already is.

"It should matter, Stevens and it does. How dare you criticize a fellow surgeon when your own competency should be called into question?" Dr. Bailey interjected, her eyes sending daggers at the blonde surgeon.

"Okay, then where is she?" Izzie asked loudly, her voice tripled in volume.

"Could you keep your voice down, Stevens? You know that you're speaking with your Chief of surgery of Seattle Grace Hospital which means I decide what happens in my hospital-" Izzie cut him off, apparently she didn't think about the upcoming consequences or she just didn't care at all.

"Where is she?" She repeated her question in a loud demanding voice.

"If she has a so called problem with me, why isn't she here to speak up? Or is she hiding somewhere? Avoiding because god knows that that's her way of dealing with things she doesn't like. She runs because she is scared to face whatever's bringing her down. She runs and avoids is what she does. She's an avoider, a coward." Izzie scoffed, feeling better after she let this off her chest. Cristina and her other colleagues threw shocked glances through the room. For a moment, it was deathly quiet in this room. Then Cristina Yang stepped forward, a wild expression on her face. "Cristina, don't do anything stupid, okay, don't do anything stupid right now." Burke's voice came down from behind but Cristina didn't seem to hear her.

"Cristina, Cristina, don't … whatever it is, don't do it, it's not worth it." She seemed like she was on autopilot.

She stepped toward Izzie and her hand slapped across Izzie's cheek before someone was able to stop her. Shocked silence was in the room. Izzie was stunned, she hadn't expected Cristina to do this, to step of for her friend but apparently, there was a whole lot she didn't knew about her *friends*, not that she's really been a friend to them lately. "She is anything but a coward. Don't you dare to say this ever again or I will be not as nice as I am right now." Cristina Yang gritted through her teeth. "Dr. Yang." Bailey's voice called her back and Cristina immediately let go of Izzie Stevens. She doesn't want to do the same mistake as her. "This won't help anything. So let's get back to the point. Why are you treating Dr. Grey as if you had no respect for her at all?" She directed her last words at Stevens who shifted uncomfortably.

"She hit me." Izzie exclaimed, as she pointed to Cristina.

"For which she's apologizing to you." Bailey answered and looked at Cristina. In her way she was telling her to do this. Resisting, Cristina apologized quickly, not even remotely meaning it.

She would do it again to defend her friend's honor.

"But …"

Izzie couldn't believe that nobody seemed to care about the fact that Cristina did what she did. "Stevens, we're all adults here." Dr. Webber shushed her with this sentence. "What you said about Meredith is wrong, entirely wrong." Izzie thought, it was for sure that they would take Meredith's side.

But there are always to sides of a coin to every story.

"Let's get back to the point. And why did you start with what you were doing after she got back from her sick leave, the leave she took to recover from open heart surgery? Why is all I want to know …"

Izzie didn't respond at all. But they all waited for her to answer the question.

"Stevens, answer the question." The Chief bellowed, he started to reach his rope with Izzie Stevens and it now clearly showed.

But Izzie stalled, apparently.

"Okay, you don't want it to go this way? Fine, have it your way. I expect you to play nicely together in our sandbox, okay?"

"Oh my God … this is …" Izzie scoffed.

_Sandbox?_

"This is the limit. Stevens, Stop being so disrespectful to your superiors." Bailey interjected, anger sounded through her voice. She couldn't believe that one of her interns was doing something like this. It was not right.

She hasn't raised them to act like this.

She just didn't say anything, not a single word.

Izzie's just been staring at the wall for the past five minutes. Dr. Burke kept looking onto his watch. He knew that he a surgery scheduled in about half an hour and Meredith Grey was prepping the patient. "I have time, Stevens, just so you know. I can sit here as long as I need to. There are no surgeries or meetings scheduled today. We will get to the bottom of this." He said in a harsh voice.

Then he added, in a not very friendly tone: "Now speak – sharp's the word!"

"Is this supposed to scare me? It doesn't."

Izzie laughed and stood up from the chair she was sitting in. "You're not scaring me one bit. I hate to disillusion you, but I'm going to go now. This has gone on long enough. I have better things to do than sitting here and listening to you." The Chief exchanged glances with Dr. Bailey, they were communicating without needing any words.

"If you walk through that door, Stevens, I assure you that you will lose your position in my surgical program. You're supposed to listen to what your superior has to say. Right now that's me. And now listen to me very carefully …"

Dr. Webber made a meaningful pause.

He now saw that Stevens was scared when he mentioned the loss of her position at Seattle Grace Hospital.

"… I meant what I just said. Either, you're going to cooperate or you won't work here anymore. It's your choice and it's very simple. It's simple. Why have you been doing this Meredith?"

Dr. Webber stared at her.

"I am not going to talk now. It'll probably make this a whole lot worse." Izzie declined. "I don't want to add fuel to the fire." "You don't want to add fuel to the fire? You chose to remain silent? That's the first smart thing you've done." Bailey scoffed unwillingly. "You owe Dr. Grey a public apology." "Okay." She finally relented, resignedly. "Maybe I owe her an apology for the way I treated her. Maybe I do." Finally, she accepted that she did something wrong. Dr. Bailey questioned her question: "But why did you do it? We just want reasons." "Well, I … don't have any reasons." Izzie stuttered, overwhelmed. Cristina's face instantly darkened and so did Alex'. Izzie realized that they were all on Meredith's side. She remembered what she once said to Meredith when there was this thing going on with her and George. _If it comes down to choosing sides, if you can't repair this, I'm on his._ Apparently, it was now the other way around. She realized that now. "You don't have a reason? So just decided it was okay to treat her like she's not worth anything?" That was Cristina again. Izzie didn't respond. It was just easier.

"I don't have any ideas how you could do something like that. She's your roommate. She's been so kind to allow you renting a room in her mother's house, her house. Why'd you do this? Jealousy – is that the reason for all this, Stevens? Is it that?" Cristina asked her. This was hitting close to home.

"Yes, okay? Yes, that's the reason."

Cristina looked at her in disgust. This was unbelievable.

How could she do that without feeling something like remorse, maybe? This was unexplainable to her. Meredith was oblivious to the whole situation. But she was probably wondering where they all are. "You can't be serious. Seriously, you can't be serious. This is crazy. Why would someone do this to someone they are friends with?"

"We just work together, nothing more."

Cristina stared at her.

Izzie looked at her with a face that told her that she didn't really care about what would happen. "She is the owner of the house, you know that right?" Cristina asked slowly, trying to comprehend what just happened. Izzie Stevens chuckled condescendingly. "Of course I know that. She agreed when I asked her if I could move in. It's a cheap solution if you don't want to rent in the city."

"You are using her." Cristina shot back.

"You're using my best friend. Shame on you for doing that ..."

When the discussion grew too heated, Dr. Webber interfered. "Okay, let's just all calm down for a minute. The interns wait outside, please. I need to talk to Dr. Bailey and the attendings."

"We are the best surgical program in the west, an upstart programme that no one ever heard of, that blew everyone out of the water. But if we don't watch out we'll get old, entrenched and sloppy, just like everybody else. And this can happen overnight. We've been resting on our laurels. You have all been failing ... failing to take initiative, failing to ask tough questions, failing to practice your skills, failing to give opportunity to practice skills, learning respective behavior toward colleagues and superiors. And I let it happen. So you have not failed, we have failed."

Indistinct chatter followed and could be heard. Some attendings were whispering.

"Well, it stops, and it stops now. People sliding over general surgery as though they will never see anything but a heart or a brain through the course of their career, as though blood from the heart doesn't make its way through the whole body or the nerves don't travel past the brain stem. It's shoddy teaching and it makes for shoddy surgeons. We've failed. Get it? We all have. And it stops now. The surgical training protocol is officially changing, people. The bar has been raised ... Inappropriate behavior won't be condoned. We're a hospital with sick people. You will treat everyone with the respect they deserve. I haven't thought that I would have to tell you that. Disappointing, very disappointing."

After he finished his speach, all people cleared out, slowly. "Stevens, you just earned yourself a week off without pay. Addionally, you're on probation for the upcoming months and banned from the OR for the next two weeks."

"Wow." Alex was surprised.

This would be pretty hard for Izzie. He saw her face expression, embarrassed and red. But it was all her fault.

She could have decided to support Meredith and not making her life hell.

* * *

"Okay, that's it. Go back to work now." The Chief dismissed everybody after he announced Stevens' punishment.

She's on probation for next upcoming months. "Guys, you're dismissed." "Come on, Yang, let's go. We've got tons of work to do now." Cristina just followed him without any questions because she knew he was talking about their patient Meredith was currently prepping.

Derek, Montgomery and all the other department heads that were attending, walked out of the Chief's office. Cristina has catched a tiny glimpse of Derek in the crowd as she followed to the elevator. After this meeting, Dr. Burke went back to work. He motioned Cristina to follow him since they were now doing the TAVI or TAVR. When they were both in the elevator, Dr. Burke cleared his throat before asking a question that is related to their procedure.

"What are the different approaches?"

Cristina answered without any difficulties.

"For one, there's the retrograde trans-femoral approach which we will be using because it's as minimal-invasive as possible. But there are other approaches as well." Cristina ended. Dr. Burke nodded to confirm that her answer was indeed correct. But he wanted to know other things about those procedures.

"Like …" That's when the elevator stopped with a ding and the doors opened. He and Cristina entered the hallway.

"Like the Antegrade Transvenous Approach. It means that the delivery system is advanced through the femoral vein to the right atrium across the interatrial septum and mitral valve only to be subsequently positioned in the stenotic aortic valve. It's is rarely used." Cristina answered. "And then there's the Trans-apical Approach which means the left ventricular apex is reached by anterolateral mini-thoracotomy. The valve delivery system is introduced through the left ventricular apex and subsequently positioned in the stenotic aortic valve."

* * *

"You had better go now." The Chief said awfully and dangerously quiet that meant nothing good. Izzie knew that. Everyone except Stevens cleared out. She was standing in front of his desk, her arms crossed over her chest as she continued to look at Dr. Webber. "Is this really necessary?" She asked, trying to get out of her punishment by using puppy-dog eyes but that was no use. "Stevens, this is final. You better go now before I make a stop to you mixing this place up. I want you to behave in my, in my hospital. You work for me, got it? Consider your on notice."

"Yeah, I know that, sadly."

_On notice?_

Izzie swallowed. This was hard. This was hard for her.

Unfortunate.

"Okay, no, this is enough. Get OUT of my office, NOW." Izzie flinched at the high-pitched sound.

This wasn't going to go her way. This was about Meredith, as always. "This is really fucking great." She muttered as she got ushered out of the Chief's office. All the interns of her intern class where there, chatting distinctly about Izzie Stevens' stupidity to do that to a well-respected colleague of hers. They were staring at her.

She saw George and Alex in the crowd but not Cristina.

Izzie kept her head down.

She'd been stupid way too long. She needs to change that.

"What are you looking at? Don't you have better things to do?" But she never got an answer. Izzie walked toward the locker room to pack up her things. She got suspended and wasn't allowed to be back until next month. This sucks. She was angry at the whole world. What was it with them that they …

"And so it can turn around ..." Alex commented.

* * *

"Where the hell have you been so long?" Meredith exclaimed as she caught view of her superior and Cristina. "It's been over an hour and the patient is asking whether she is still getting surgery today or if it needs to be rescheduled …" Meredith got them up on speed on the latest happenings. She did a CXR, drew the patient's blood and did everything as she was told to do.

"We had a thing that we needed to take care off." Burke answered shortly, in a way that stops her from asking more questions.

Meredith looked at Cristina who avoided looking at her. She knew that her friend didn't want the Chief to be involved in this but now he was. "So the surgery's still scheduled for today?" Meredith wanted to know.

"Yeah, of course it is. Let's go see the patient, shall we?"

After they entered the room, the patient immediately asked the questions she didn't ask before. "So how does this work?" The patient asked as soon as they entered the room. Dr. Burke tossed a glance over to Meredith who instantly catched the hint and started explaining how this whole thing works to the patient. "You will have some tubes put through the blood vessels in your groin to deliver the contrast dye and a pacing wire to speed up the heart during the valve insertion to ensure correct positioning. The surgeon will gain access making a small incision either in your groin or chest wall. We'll go in through a small incision in your groin." Meredith explained.

The patient listened attentively. "Thank you, Dr. Grey. Dr. Yang, would you go on please?"

"Sure thing, so … A catheter, a narrow tube, is passed from the femoral artery to the aorta. After the procedure, you will be monitored in the Surgical Intensive Care Unit for at least 24 hours. Once you are stable, you can be moved to a regular ward and, over the next five to ten days, you will recover and prepare for your discharge." Cristina reacted.

"Okay, I can live with that."

Soon the patient and the doctors were in the cath lab. Dr. Burke injected the contrast dye after the patient was sedated and has received general anesthesia so she will sleep through the procedure and not feel any pain during the procedure and access was gained through a small incision. It wasn't just Burke and his interns in this room. There was a specialized team that includes an interventional cardiologist and a cardiac anesthetist who specializes in cardiac ultrasound imaging. They are using the specialized ultrasound and X-ray imaging. The catheter allowed a balloon to be placed into the patient's tight valve, the balloon is inflated to stretch the valve open.

"This part of the procedure is called balloon aortic valvuloplasty also known as BAV. The new valve for implantation will be carefully compressed and mounted onto a balloon delivery catheter."

"We know." Cristina and Meredith both said in sync.

When the valve is in the correct position the heart rate has been increased using the temporary pacing wire for a few seconds. "Why am I doinf this?" Burke directed his question to his fellow surgeons. "This reduces the blood pressure and the motion of the heart making the procedure safer. The balloon is then expanded opening up the replacement valve in to a permanent position." Cristina answered.

"Well done."

The balloon was deflated and removed leaving the new valve to function immediately. In order to insert it into the heart, the valve is squeezed around or inside a catheter. The catheter was then inserted and guided to the aortic valve opening in the heart where Burke implanted it over the existing valve.

"Once it is correctly positioned, the new valve is implanted over the current valve." Dr. Burke said as he positioned it. Dr. Burke looked at the monitors as did Meredith and Cristina. They were watching every move he was doing. The results were satisfactorily. The catheter is then removed and the new valve began to work immediately. Then he looked up and asked: "What can you tell me about the valve I'm implanting?"

For a moment, there was the cardiac monitor the only thing that made any sounds at all.

"Trans-catheter aortic valves are specially designed for this procedure. The valve is made of natural tissue from the heart of either a cow or a pig. The natural tissue is re-engineered and attached to a flexible expanding mesh frame."

* * *

Derek walked into their living room. He saw Meredith sitting on the couch, reading the _Journal of Neurosurgery_. She did that now, reading in Derek's journals concerning his field of expertise. She seemed so intrigued in one article that she didn't even notice that Derek had set a foot in the room. Her eyes were fixed at the page of the journal, reading. He smiled a dreamy smile at her knowing she was in her own world. He was happy that neurosurgery was the field she was interested in.

It could have been any other field. And there are many other fields for that matter.

Derek slowly entered the room, and then he was sitting down next to Meredith who looked up when she heard him. "Hey, Derek, you already home?" She asked.

"Yeah, I got home early, wanted to be with you."

He was still smiling that adorable McDreamy smile. "What about you?" Derek kissed her quickly on the cheek.

"I studied but then it got boring so I called Cristina but she had a thing going on with her boyfriend – that I was interrupting – so I had come up with ideas to entertain myself on my own. I had a pizza. Since I was alone, I turned up the music for a little while to relax … and now I am here, reading a particularly interesting article about ... something …" Derek only has seen her get this excited about neurosurgery. So he figured she was reading something about neurosurgery. It was kinda like a given for those who knew her like he does.

This conversation was light and funny. Sometimes it was good to have these kind of conversations and not always about work ...

"About something … Come on, enlighten me." Derek asked her with a smile.

"Yeah, I read something about a clinical trial in patients with traumatic brain injury." She replied with a smile. "Oh … and you have read nothing about pediatric cardiology?" Derek asked even though he didn't really know why he asked that question. "Then I'd be looking in the wrong journal. Come on here, Derek. Have a seat next to me."

Well, she was right about that one. If she was looking for that, she should be looking in the_ Journal of Pediatrics_.

Derek didn't wait for her to ask him a second time. He sat down and wrapped his arms around her and then he buried his nose in her neck and breathed in her scent. "Meredith?" Derek asked suddenly, there was happiness in his voice. Meredith looked up, followed by a soft reply coming from her. "Yeah?" She asked.

"There is something I want to give to you and I haven't done it yet." He said, being secretive.

"What is it?" Meredith asked as she eyed him. "Wait for me, Mer. I will be right back." Derek didn't wait for a reply coming from Meredith. He left the room and then came back seconds later Meredith and Derek were sitting upright on their bed, leaning against the wall. Meredith wore a red shirt she looked fabulous in. He was sitting next to Meredith. His hand was on her shoulder, softly squeezing it. Meredith was looking at the engagement ring he gave her.

Her eyes shined as she scanned it.

He thought he could see slight tears shining in her eyes.

"So you like it?" Derek asked, he was kind of scared of her answer.

"I do. Yeah, it's small, nothing big but it's … perfect. I love it, Der." Meredith assured him, a smile was covering her face. "Well, then …" Derek said. She looked radiant. "So at this point, maybe we should start planning where we want to go for our honeymoon." Meredith suggested. "Maybe we should go somewhere cold? I thought maybe Canada or Alaska. I hear they have good places where you can catch trout and other kinds of fish." Derek looked at her.

"Well, the way I'm seeing it is that in that case we won't even have to leave Seattle. Hence the fact that it's cold here pretty much every day except maybe in the summer." Meredith replied. "So what do you think?" Derek asked Meredith who contemplated her answer.

"I'd love to visit Hawaii." She then said. "The Aloha State." Derek stated. Meredith nodded.

"Yeah, I mean the Aloha State."

* * *

"Most frequent cause of diarrhea in hospitalized patients." Cristina asked Izzie. "Rotavirus, no, no, salmonella ..." Izzie corrected but it was wrong anyhow. "Diarrhea in hospitalized patients causes that." Cristina repeated. "Most frequent cause of diarrhea in hospitalized patients is C. Diff. It can lead to toxic mega colon, perforation, sepsis and death." Meredith got it right at the first try. "You suck." Izzie grumbled. "I had lot free time, thought I should study so I could kick all of your asses." Meredith grinned. "Right, Cristina?" "Yes, Ellis Grey's daughter." She answered. Meredith frowned. "You're just jealous because I make you look like losers." "You bet we do."

"Who wants coffee?" Meredith added after answering that question.

"I want." Izzie called out and held her cup up. "Wait, you have to earn it. What's inside the carotid sheath?" "The internal carotid artery, the internal jugular vein and the vagus nerve is inside the carotid sheath." Izzie answered. "Can I have my coffee now?" Izzie asked warily. "Ok, that was too easy. Let's find you a hard one." Cristina looked through the flashcards. "Hah, found one." "Give me that." Meredith wanted to do the next question.

"What is MEN syndrome?"

"No idea." Izzie replied.

"Does anyone want coffee?" "You have to know these answers, Izzie. They might ask you that on the test." Cristina lectured her. Izzie rolled her eyes. She wasn't in the mood for a lecture. "Multiple Endocrine Neoplasia is the correct answer to that question." Meredith answered even though she wasn't asked. "It wasn't your turn, Mer but correct." Cristina grumbled but then added: "Since you seem to know every damn answer in the book …" Meredith looked at her friend expectantly.

"What does TCPC mean?" Cristina pointed with a flashcard at Meredith that had that question on it.

"It means Total cavo-pulmonary connection. It's the last stage of the Norwood surgery series." Meredith answered. This was so easy for her. If the test was only some stages more difficult it wouldn't be a problem.

"Why am I even bothering to ask a question that's cardio or more specifically, CHD-related?" Cristina asked no one in specific. Meredith only smirked.

"Wipe that smirk off your face." Alex looked at Meredith. "Please, no making fun of our …"

"… practically non-existent progress."

Meredith sighed.

"I promise I won't do it." In that moment, the neurosurgeon with the perfect hair walked through the kitchen. His brow furrowed when he saw all the people sitting there around the table, having their noses in books and flashcards and he assumed they were studying for the intern exam.

* * *

Derek's pager went off after he started eating his meal. Of course it did. He looked on it and groaned. Mark was there as well but unlike him he hasn't been paged. "What is it?" He asked, his mouth half-full. "Burke's paging me. He wants me to consult on his TAD patient from a week back. He finally woke up." "So he wants you to do an exam to assess his neurological status." Derek only nodded. "Seems like I don't get to eat my lunch this time …" Then he muttered under his breath, adding, "So much for lunch break …" "It seems like you have not got choice but to do Burke this favor." Mark pointed out. "Thank you, Mark, for pointing out the obvious." Derek said sarcastically as he got up to answer the incoming page. "No problem, bother."

When he reached the patient room, Dr. Preston Burke was already waiting for him, he was pacing up and down nervously. Even though it was good that his patient had woken up, he still feared that there were gonna be additional problems of _neurological_ nature. Which means he had to page Derek, knowing that he got called away from his lunch.

"Burke." Shepherd called out, drawing attention to himself.

"Shepherd, I'm glad you are here. I need you to assess my patient. Mr. Brown. Six days post-op an emergency procedure due aortic dissection. He went into VT the morning after the surgery-" "I know, Grey handled the code. She told me about that." Derek interjected. Burke ignored his comment and said: "He was put in a medically induced coma to prevent it from happening again. Now he is awake but complaining of an headache, I've watched intermittent loss of consciousness over the last few hours and the patient also appears to be confused." Burke told him.

Derek turned to his intern.

"Symptoms?"

Alex was caught off guard for a moment but then he got it.

"Mild to moderate hypoxic brain damage may cause headache, confusion, decreased concentration and attention span, mood swings and/or personality change, intermittent loss of consciousness, poor coordination, seizures can occur as well." Alex Karev said who was on Derek's service today. Derek didn't respond, he just looked at Alex Karev and eventually it occured to him that Shepherd wanted him to go on. "Uhm, severe ..." He started but broke off again.

"You can do it." Derek told him.

"Severe damage may lead to a coma or a vegetative state. It can also happen that there is a decline in brain function a few days or weeks after the event occurred. This is caused by delayed injury in the brain. But it happens rarely." Alex added. "That's correct." Derek confirmed.

"So, here's what we do: I perform a neuro exam, take his medical history- does he have family?" Derek suddenly asked. Because if he was in that situation, his family would be there for him and he would want them to be there for him.

"Yeah, he has family. A wife and his parents."

"Let's inform them about the progress. Ask them to come here." Derek ordered, motioning to Karev who got the hint. He was supposed to do that. "We'll inform them after we do the tests.

"So what course of treatment would you do? Starting with the initial treatment." Derek asked his intern.

"Depends on the cause." Alex answered shortly.

"That's right."

They treated him with oxygen to increase the amount of oxygen in the blood right after the code, addionally, the gave him medication to help get adequate oxygenated blood to the brain. Another treatment option would be to cool the brain to help limit brain damage. "So, let's get him to CT." Dr. Shepherd said and with that he also means the other tests they need to do to determine whether or not it is the right diagnosis and learn the extent of the brain damage and the part of the brain that is involved. They did a head CT scan, also an MRI scan, a SPECT scan (a type of CT scan that examines areas of the brain for blood flow and metabolism) ...

Derek also did a test that measures the electrical activity generated by the brain called encephalogram or short, EEG and evoked potential tests which means tests used to evaluate the visual, auditory, and sensory pathway. "Karev, you stay here and wait for the family to show up. I am counting on you." Alex sighed.

"Sure, no problem, Dr. Shepherd. I will do that."

Derek glanced at him for a second before asking: "Do you want something to add? If so then speak up."

Alex only shook his head.

"Nope, I'm all good." Alex answered

Alex was writing in Mr. Brown's chart as a nervous and scared couple, along with a younger woman, came walking into the room. Derek Shepherd and Preston Burke had taken Mr. Brown for some test to determine how bad it is. He was now officially waiting for the family. A nurse had called them to tell them that they should come. It had taken them an hour to get there.

But now they were here.

"Where is he? Where's Chris? How is he ..." A hysteric voice said. Alex looked up- only to see some people standing there. Immediately, he put the chart aside.

When she saw that Alex was the only one in the room she exclaimed panicky: "What happened? Where is he? Did something happen?" Alex didn't have any time to answer.

"He's been taken down for tests. Dr. Burke and Dr. Shepherd should be here soon."

"Dr. Shepherd?"

"He's the neuro consult." Alex looked at them with a straight face, not giving anything away.

"But his brain was okay or do you think it's something wrong with his brain? Something you haven't caught yet?"

"Let's just wait for Shepherd. He should be here any minute."

They all got more nervous as they waited for the arrival of the neurosurgeon. Then he was back, together with two nurses pushing the patient's bed back into the room and of course, Dr. Burke, the leading doctor on the case. "How is he? You said that he woke up?" She looked at him.

The breathing tube was gone, an oxygen mask was now covering his face and providing additional oxygen.

"He did but he was confused and showed other symptoms of anoxic brain injury. It was probably caused by his going into cardiac arrest a few days back." Dr. Shepherd explained the condition, what it meant for the patient and his relatives. The family was shell-shocked. "Does he know us?" His wife asked who seemed to be his age. "We'll have to see how significant the damage to his brain is. We can't give you the exact information."

"Oh my god."

"What can you say about his rehabilitation?"

"That's a difficult question to answer. We can't really give an exact number or something. Recovery from brain damage can be uncertain. It will also take time. His chance for recovery depends on how long and how severely he was deprived of oxygen. Many people with mild brain damage can usually recover most of the lost functions." Alex explained.

He'll most likely need a physical therapist to retrain motor skills, such as walking, as well an occupational therapist to help improve daily skills if neccessaey, such as dressing and going to the bathroom. Your son and husband may also need a speech therapist to work on language problems. Also, there will be counseling, for the family. This is hard on everybody. The patient and their relatives. So there will be a psychologist as well for behavior and emotional issues related to the injury."

"O ... Okay." His mother stuttered, apparently overwhelmed by what is happening.

"What can we expect?" The father asked, putting an arm around his wife. "Concerning his recovery, I mean ... how long does it take?" The question was lingering in the air.

"Recovery can take months, or even years. In many cases, full recovery is never achieved, but some can successfully learn to live with any remaining disabilities. In general, the sooner rehabilitation starts, the better the outcome."

* * *

_Derek was sitting with Meredith but at some point he was paged to some patient of his. "Are you sure I can leave you alone, Mer?" He'd asked with glimpse of worry in his eyes. But her condition wasn't that worrisome was it? "Yeah, sure, I'll be here sitting and monitoring my patient." She shrugged it off. But she hasn't slept. "You have pre-rounds in thirty minutes, Meredith. Bailey won't like you skipping pre-rounds." Meredith smiled at him as he tried to warn her. But she knew what she was doing. "If she doesn't like it, she should take it up with Burke who ordered me to monitor this patient." Meredith shrugged and suppressed a yawn. Twenty-five minutes later, Meredith was still sitting on a chair at the nurses' station and was monitoring the trauma patient. For now, he was stable but she was worried about his blood pressure. They barely have been able to get it to a point where it could be considered as stable. In this moment, she noticed his BP was tanking, his ECG was going into a wide-complex arrhythmia. It means VT until proven otherwise._

_She got up from her chair faster than ever but before she could make it to the room, she heard the heart monitor beeping erratically in distress. He was going to go into cardiac arrest. He was about to flatline, or more, he would if his heart kept this pace up. That's not how she imagined start her shift._

_"Oh no, this can't be …!" Meredith exclaimed as it dawned on her what she was in for… Of course this was happening during her shift. Who else should it be? Then he started crashing, the patient's state took yet another dive downward. This was so not good. It was not good at all. But Meredith Grey can handle running a code without freaking out. Maybe he was tamponading again. She hoped not because if he did she was obligated to page Burke to handle this. She jumped up, sprinted into the room at record speed, a nurse who watched this was following too and was pushing the crash cart into the room. "I'll get the crash cart right away." She called out. Then she pushed to button and a computed voice said over intercom repeatedly: "Code Blue, ICU. Code Blue, ICU." Meredith didn't listen anymore._

_She had more important things to do right now. "Code Blue, ICU …"_

_-/-/-_

_Meredith grabbed the paddles. The patient already had percutaneous pacing pads applied to his chest._

_"Charge the pads to 120." Meredith ordered, calmly._

_"Charge … Clear."_

_The nurse pressed the button. She pressed the paddles against the patient's chest and waited for the heartbeat to normalize itself. The shock sent the patient's body flying upwards. But the first loop wasn't successful, Meredith realized. She'd have to repeat this. She was using a biphasic defibrillator device. "Anything?" "No, nothing." The nurse replied as she focused on the monitor. Meredith shook her head in desperation. "Charging. Nineteen seconds." The nurse pressed the button who is for the second round. "Charge them to 200." Meredith called out. _

_"200. Twenty-seven seconds." And this time it worked. The patient was good. _

_"We've got him back." Meredith said as relief was flooding through her body. The cardiac monitor showed a normal sinus rhythm. That was good. After she got the patient stabilized, she put him on Amiodaron prophylaxis to keep it from happening again._

_She singlehandedly saved this patient. She could be proud of herself. Meredith was, she felt pride over her save. She did that, gave him a second chance. But what about his brain, is it okay? They would need to do further studies to find that out. He'd been oxygen deprived for a long time, the time in which his heart wasn't beating. Maybe he could have brain damage. Maybe, there was a possibility. Meredith knew that. She was aware of the odds. _

_Anoxic brain injury__. Bailey asked her about that yesterday. _

_"Can you take over for me now that he's stable? Page me, Dr. Burke or Dr. Yang if there are any irregularities in his heart rhythm or change in hemodynamics etc. I have pre-rounds." Meredith explained and for once nurse Debbie just did what she was told to do. Meredith jogged to where she knew Bailey and the rest of her group would be. _

_When Bailey heard her, she turned around, a bit agitated by her intern being late._

* * *

Meredith woke up early, even before her alarm clock started ringing. So she did herself a favor and turned it off before it had a chance to start ringing. Today was test day. But Meredith wasn't nervous. Why should she be? There was no reason for her to be nervous, because she could do this. She was prepared. Her bed was warm and cozy and just so comfortable which made getting up so much harder. So today was it. Time of truth was there. Today Meredith and her fellow colleagues are taking the test. Meredith got up quite early so she would avoid too much stress.

When she opened the fridge, she saw Derek prepared something for her. There was a note as well.

_You can do it. I believe in you. Hugs and kisses, Derek. _

Meredith smiled at the sight of this. This was so sweet of him. She started eating, contemporarily she was making was test day.

"Please take your seats, doctors." The proctor said as Meredith and the others entered the room in which the exam should take place. "Put all study materials away." The proctor started with the safety instructions. Meredith, Cristina and her intern colleagues listening to what she said.

"If you don't know the answer, choose _B_. It's always _B_." Cristina said, giving away suggestions that may or may not help during the exam. "Write your name in the upper right-hand corner of your answer sheets." Izzie was now coming through the door and walked over to a free seat without even looking at Meredith or Cristina. Cristina and Meredith exchanged glances but their attention was soon needed someplace else. When every intern was sitting on a chair, the woman cleared her throat to get their attention. Within seconds, every intern in the room fell silent. "You may open your test booklets … now. The test starts now. You have 120 minutes to complete the test." The proctor said as she looked on her watch. Time was on now. Meredith opened up the first page of it. She looked over the questions and read them carefully. She knew the answers to those questions. But since this was multiple choice-questions she had to be extra careful that she ticks the correct one but she was managing. These questions were really easy. Her pen rushed over the test paper. After an hour, there was a new announcement.

"We're halfway through our allotted time, doctors. You only have 60 minutes left to complete the exam."

The proctor walked across the room, through the table series, she looking on the tables, sandwiches are laying there and open water bottles on the tables.

Meredith never looked up from the paper.

She just kept on reading the questions and ticked the correct boxes of the questions.

When she was sure it was answer A, Meredith Grey read the other ones again in case she read over an important detail that told her that the right answer was not in answer A but answer B, C or D. She had absolutely no trouble answering those questions. After another thirty minutes, Meredith finished up. But she wanted to review her answers to be sure she did it correctly. She looked her test fully over once. She was confident the majority of her answers was indeed correct but only time would tell. But she also knew that she shouldn't be so nervous about it. She was just grateful that it was almost over, that she wouldn't have to study all day long. Instead, she would get to do the things she liked.

She would get to spend time with Derek again. She was looking forward to that.

But before she was doing that, she quickly refocused on the test.

* * *

Derek was in the operating room operating on an elderly patient with a chronic subdural bleed at the same time Meredith was writing her intern test. He kept looking at the clock that was in the OR. He was a little nervous because he knew that Meredith had to take the intern test today. Derek had no doubts that she would pass it but he couldn't help but worry. He knew that this test was supposed to take two hours. So Meredith would be finished soonish. He sighed and closed his closed while stretching his neck from one side to another in the hope to release some tension.

He didn't like the fact that he was stuck in the operating room when Meredith is probably working on finishing the intern test and that he wasn't there when she got out of the room.

Again, he looked over to the clock before refocusing on his job.

But at some point, he told himself that Meredith was able to do this and that there was no need for him to worry about something he didn't need to worry about. And he was right.

Meredith was starting her second reviewing of the test answers.

She had an overall good feeling. But she was so grateful that she was done whatever the results were. But only time would tell if she has passed and what rank she was ...

Meredith was aware of that.

"Time is up, people. Now I want you to put your pencils on the table and turn around the test. No one is allowed to leave before I haven't collected the exams. Then you're free to go." The woman, who had watched them throughout the two hours, eyed them dutifully while she told them what they are supposed to do.

Collective groans erupted from various parts of the room. Meredith didn't bother to look where they came from.

Maybe they haven't been able to finish or something. But she didn't really care. Meredith turned her test around and waited patiently for the proctor to pick it up. She tried to catch Cristina's eyes who offered her a somewhat wry smile. Soon after that, the proctor announced that they were free to go. She looked for Cristina. A group of this year's interns was leaving the room. Meredith wisely stayed behind. She could wait. Cristina must have thought the same because suddenly, her person was standing behind her. "Cristina, there you are." Meredith said, smiling. She was relieved that it was over now.

"Meredith, tell me, how did it go? Did you have any trouble with any questions?"

"I'm positive I totally winged it. As for your second question, no I didn't have had any troubles with any questions." Meredith laughed. Cristina looked at her for a moment. "Really, you had no problems with questions number forty-five, the endocrinology question?" Meredith shook her head in reply. "How about you?" She asked Cristina. Cristina followed her example. "See, I have the same feeling." "So that's good right?" Meredith asked, a bit unsure. "Yeah, think so. All we need to do is not to start freaking before we get our scores back. Best thing to keep my mind of it is a long and bloody surgery." Cristina said.

"Tell me why it doesn't surprise me at all." Meredith countered, smiling.

"Because I am Cristina, Meredith and I'm always focused on surgery. I'll go find Burke to see if he has anything interesting scheduled."

In that moment, Alex came passing by. He saw that Meredith and Cristina were the last ones to leave the room.

"Hey, how'd you all do?" He asked, wanting to know how they did on the test. "I think we did it quite well." Meredith answered for the both of them. "I have a good feeling as well." Alex replied. "Do you now by any chance how the others did?" Cristina interjected, apparently joining their conversations. Alex looked at her for a moment. "Honestly, no, I have no idea nor have I asked them about their feelings about this test." Cristina nodded. "I'll go find Burke now." She said. "I will see if Bailey has a new assignment for me." Alex added. "Are you coming with me?" "I will after I see Derek." Meredith answered his question. "As far as I know, Derek's operating right now. He is in OR 1." Alex told her. Meredith smiled at him before replying. "Fine, I'll just go to the gallery." Meredith shrugged. Derek operating right now wasn't a problem for her in any way. Alex and Meredith soon went different ways. Meredith was on her way to the observation gallery of OR 1.

Meredith looked down at Derek performing a flawless craniotomy on some patient after entering the observation gallery. She was alone there. Nobody else was watching this surgery and somehow, she was happy that it was just her there. Maybe Derek would look up at some point. Meredith was positive that he would feel her presence at some point.

But she didn't use the intercom to communicate with him.

She didn't want to disturb or distract him. It was delicate work he was doing down there. She looked through the windows, watching him operate. Suddenly, he looked up. That was what Meredith had hoped for. That Derek would look up and see her sitting there on a chair, in the gallery and watching his procedure. It was like it was sixth sense or something and he felt like she was there.

She sent him a big smile to let him know that her test went really well.

She decided to wait for him to finish his procedure but it seems like her resident has other ideas in mind. Meredith's pager shrieked loudly. Immediately, Meredith knew that she has to go back to work now, even before she looked at her pager. It was indeed Bailey paging her. When Derek looked up again, Meredith wasn't there anymore. He figured that she had been paged. Meredith walked to room 14409 where Bailey was expecting her.

"Grey, there you are." Bailey said as soon as she got view of the young doctor. "I have some work for you to do." She started in her usual manner, her face showed her usual scowl.

By the look of Bailey's face she was in for a boatload of charting.

"Go for it." Meredith only replied as she faced Bailey.

"I have a parathyroidectomy scheduled later on and I still need someone to scrub in which will be you if you finish these charts and deal with today's discharges." The general surgeon also handed her a stack of paperwork.

Then she held up one blood sample. "I also need you to run this for me, as soon as possible so that I can enter my well-earned lunch break." Before Meredith had a chance to react Bailey was gone and leaving toward the cafeteria leaving her with no choice but to do what she just said.

* * *

**A/N: So here is the update you've all been waiting for. I won't update regularly since highschool has started for me ... I'm just adding this, in case you're wondering why there aren't many updates. I will _not_ abandon this story, no matter how much time has passed.**

**Please review.**


	45. Chapter 45

**Chapter 45**

* * *

**My mother used to say this about residency, "It takes a year to learn how to cut. It takes a lifetime to learn not to." Of all of the tools on the surgical tray, sound judgment is the trickiest one to master. And without it, we're all just toddlers running around with ten blades. We're human. We make mistakes. We mis-estimate. We call it wrong. But when a surgeon makes a bad judgment call, it's not as simple. People get hurt. They bleed. So we struggle over every stitch. We agonize over every suture because the snap judgments, the ones that come to us quickly and easily without hesitation, they're the one that haunt us forever. **Sympathy for the Devil; Meredith Grey

* * *

Meredith looked down at Derek performing a flawless craniotomy on some patient after entering the observation gallery. She was alone there. Nobody else was watching this surgery and somehow, she was happy that it was just her there. Maybe Derek would look up at some point. Meredith was positive that he would feel her presence at some point. But the young doctor didn't use the intercom to communicate with him. She didn't want to disturb or distract him. It was delicate work he was doing down there. Meredith knew she should probably find Dr. Bailey and ask her for her assignment but somehow she just couldn't leave the OR gallery because the surgery Dr. Derek Shepherd was performing right now on one of his patients was way more interesting and tempting than doing grunt work like running labs, complete patient charts and everything that somehow goes that way. Meredith loved watching Derek work. It was amazing. Simply amazing and she wanted to be able to be doing that.

She looked through the windows, watching him operate. Suddenly, he looked up. She saw in his eyes that he was smiling as soon as he saw her. Even if he was wearing a mask, Meredith could make it out. That was what Meredith had hoped for. That Derek would look up and see her sitting there on a chair, in the gallery and watching his procedure. It was like it was sixth sense or something and he felt like she was there. He did look up. She saw the silent question lingering in his eyes. _How was your exam? I hope you aced it._

She sent him a big smile to let him know that her test went really well.

She decided to wait for him to finish his procedure but it seems like her resident has other ideas in mind. Meredith's pager shrieked loudly. Immediately, Meredith knew that she has to go back to work now, even before she looked at her pager. It was indeed Bailey paging her. When Derek looked up again, Meredith wasn't there anymore. He figured that she had been paged. Meredith walked to room 14409 where Bailey was expecting her.

"Grey, there you are." Bailey said as soon as she got view of the young doctor. "I have some work for you to do." She started in her usual manner, her face showed her usual scowl.

By the look of Bailey's face she was in for a boatload of charting.

"Go for it." Meredith only replied as she faced Bailey.

"I have a parathyroidectomy scheduled later on and I still need someone to scrub in which will be you if you finish these charts and deal with today's discharges." Bailey said in a voice that indicated that no one, absolutely no one, was not listening and obeying to what she wanted. In some way, Bailey wielded as much power as the Chief of Surgery. The general surgeon also handed her a stack of paperwork. Meredith groaned inwardly. She knew even if she worked hard, this would take the rest of this morning. But she didn't say anything to Bailey. Of course not, you only complain to Bailey if you're crazy or nuts. But Meredith wasn't one of those things. So she waited until Bailey finished giving her the assignments. She had also told her to check on the patient in room 13370 and remove drains and so on. Then Dr. Bailey held up one blood sample. Meredith was going to do all the grunt work.

But that was because they were one intern short.

But Meredith had absolutely no idea why and that they were one intern short since no one ever told her about the meeting they had in the morning. She had been left in the dark.

"I also need you to run this for me, as soon as possible so that I can enter my well-earned lunch break." Before Meredith had a chance to react Bailey was gone and leaving toward the cafeteria leaving her with no choice but to do what she just said. Meredith glanced at the package in her hand, sighing. Then she made her way to the lab to they could run this sample. On her way to the lab, she ran into Derek, literally. She hasn't been watching out. All the paperwork she was carrying fell to the ground in a matter of seconds. Meredith bended down to pick up the paperwork she dropped onto the floor as she ran into Derek. Derek helped her without saying anything. Meredith was grateful for him being so supportive.

"Here, let me help you." Derek said, he was right there, being all dreamy and helpful.

"You don't have to do this, Dr. Shepherd." Meredith said, wanting to keep work life and private life apart. It always worked well. Well, until she met her private life at work. Derek and Meredith tried to stay away from each other but it was like a calling. They were infinite. "I know, Dr. Grey but I want to." Derek simply said. Meredith looked away and turned aside. Derek noticed the awkwardness. He reached for Meredith's chin and gently turning her head so that she was looking at him. "How was your exam?" Meredith didn't respond. "Mer, you can tell me anything." Derek prodded gently.

"I know, Derek I know this. The intern exam was actually pretty easy for me. I don't really know about the others but I have had no problems with it. But I still worry about failing which is probably weird but … And now you think I am a crazy whiny person."

"This is all just nervousness because of the intern exam. It'll be all okay. Just believe me."

Meredith's blue eyes were looking at him. "This will be over before you know and you will laugh at yourself that you've made yourself crazy about thing that turned out be nothing more than an exam that you passed with flying colors. I believe in you, Mer. Now go kick some general butt." He said.

"Well, more like grunt work." Meredith huffed.

"I can't believe I'm not a first year anymore. I'm a second year resident. It feels … different, you know." "I believe so." Derek replied. "I ... uh, I have lots and lots of work to do. Tons of work."

Derek chuckled at Meredith's attempt to say that she needed to get back to work. "Okay, Mer. I will see you later." He kissed her quickly on the cheek before departing to the OR board to see if any procedures are scheduled.

* * *

**Meredith Grey, third year med school: Cardiology rotation**

_Meredith lay in her bed, knowing her clock would soon go off. But she decided to close her eyes for the time being. Soon, it felt like nothing, the clock went off indeed. "Uggh, I hate this." The blonde girl grumbled, meaning the getting up so early. It was only four. But they had to be there in at 5 AM, in the morning. She hasn't had breakfast and her going to work without having eaten a decent meal is not exactly a good idea. Meredith was now in her third year of medical school and she absolutely loved it. There have been not many situations in which she thought about her heart. She was like any other student, young and healthy and eager to learn about the human body and its reactions. She was particularly interesting in neurosurgery. It was a given for her to go in to surgery. Surgery was in her blood. It was like she was destined to be a surgeon. _

_But Meredith was glad not to be a first year anymore. _

_It's all new and exciting, sure but it's also a lot of work. And the first two year are pre-clinic, consist of basic science courses, such as anatomy, biochemistry, histology, microbiology, pharmacology, physiology, cardiology, pulmonology, gastroenterology, endocrinology, psychiatry, neurology, etc. She was now in her third year as was her roommate Kaye. She was friendly. And they got along well, helped each other study when there where exams or anything else that qualifies as such … _

_Kaye also knew about her medical history and sometimes she would be begging her to go to her annual check-up. But Meredith never went. Why should she? She was feeling great. Meredith just didn't want to think about how deceptive medical conditions could be and CHF was one of those illnesses that can progress quietly and not showing symptoms until they have reached NYHA II – IV. And the perfect treatment window is NYHA I. _

_So that was topic of many, uncountable arguments between those two._

_ But back to her being a third year – she was really looking forward to the clinical rotations, sometimes called clerkships, where students attend hospitals and clinics. These rotations are usually at teaching hospitals but are sometimes at community hospitals or with private physicians. The typical "core", that is, mandatory, rotations taken in third year of med school are Obstetrics and Gynecology, pediatrics, psychiatry, family medicine, Internal medicine, and surgery. Fourth year for the most part will consist of electives and some mandatory rotations like Emergency Medicine and neurology. Meredith was especially looking forward to Emergency Medicine, she had no idea why but it was as it was. But the brain was interesting as well. So she was also looking forward to neurology._

_Today was her first day of her rotation in cardiology / cardiothoracic surgery. They will probably get to see a lot interventional cardiology like stents being implanted in cath lab or any other percutaneous procedure. ASD closures, VSD closures, maybe as well. It was an elective rotation which means Meredith has been able to choose. She already did her core rotations. She liked getting inside view of a routine work day of a doctor. She was especially interesting in surgery which was not very surprising considering everything. Her mother being Ellis Grey, one of the first female surgeons in the country – sure, the expectations were great._

_ But Mer managed it. Meredith was aware that it would be hitting close to home at the end of the day._

_ Meredith had been looking forward to this. Every third-year med student was doing this, in different specialties of course. She could have chosen pediatrics. But working with little kids and having to watch them suffer? No. She chose cardio. She could relate to that. The rotation was beginning in five minutes. Meredith glanced at her watch for a slight moment, then back to the others. Meredith was silent. The others didn't seem to notice her. Meredith's thoughts went to her mother who worked as a general surgeon at the Brigham and Women's Hospital in Boston while she went to Dartmouth. What would she think if she saw Meredith at her clinical rotation here at Hopkins? She'd applied for this being able to do the rotation at this hospital months ago. The Chief was Dr. Michael Davidson, head of cardiothoracics, also specialized in pediatric cardiology. He was one of the best. Meredith thought back to her surgeries, at least twenty or more years back. _

_One surgery she still could remember, could remember details. But it weren't nice details.  
_

_But she was not alone. There were a bunch of other med students with her, all equally as nervous and worked up about spending four weeks in an actual hospital and learning on real patients and patient interaction in the cardio ward. Meredith knew that she would be confronted with kids that would need open heart surgery as well._

_ Just as she did when she was a kid – this reminded her. She was nervous about that._

_ Hopefully, this would be good and not something she'd regret doing. All the other med students were chatting loudly with the one standing next to them. Only Mer stayed quiet. None of them knew her name or the fact that her mother was the Ellis Grey. They would get to know that sooner than she would have liked. But for now she was just as any other med student. If it was to get out her mother was Ellis Grey, they would be talking about her and she didn't like that. In fact, she was fairly sure that she didn't like others spreading rumours about her and her family at all.  
_

_"Hey, Mer. There you are." Someone was calling her name. Meredith turned around. It was her roommate. They are sharing a room. Meredith and the other girl ain't very close but close enough to spend time together. But she also did know about her heart. Meredith once told her, in case something happens. _

_"Kaye, you're late. Don't you have a watch or something that prevents you from showing up late at work on your first day?" Meredith noted. Kaye rolled her eye.  
_

_"I know. My watch stopped working and when I looked at the locked it was already late and got into my car and just drove to this hospital, earning a lot of angry stares coming from people who live in my complex." Kaye rambled and that's what caused Mer to chuckle. She liked Kaye's calm personality. She wasn't annoying or something, she was just there when Mer needed her. "I can only imagine." Meredith replied as a booming voice cut through colloquies. _

_"QUIET. EVERYBODY QUIET DOWN." The voice was loud and determined. _

_Whoever this was, was someone in charge, so much did Meredith figure. Mer flinched at the harsh sound but only Kaye noticed. She looked over to her reassuringly. Meredith thanked her silently. All the med students stopped talking all at once and it was scary quiet. Meredith's heart was instantly beating faster, out of fear to screw up. Then her mother wouldn't be very proud of her. "Welcome to this year's cardio rotation." He introduced himself as head of cardiothoracics. "So, you are all probably very nervous and eager to assist on procedures, am I right."_

_ The med students replied in synch: "YES." _

_The Head of Cardio grinned and said: "That's what I wanted to hear. You'll be attending rounds and pre-rounds. Pre-rounds start at five, round at six in the early morning. Be punctual." Meredith raised her hand. She had a question. But she wanted to ask it the professional way. The Head of Cardio noticed her. He gazed at her shortly. _

_"What is your name?" Now Meredith had everyone's undivided attention._

_ "Grey, Meredith Grey." Soon after Meredith told him that, realization hit him. He knew that Ellis Grey's daughter will do her clinical rotation here but who it was he didn't know until now. What will we be doing during our rotation on the cardio ward?"_

_"You'll be observing, you will be able to perform minor procedures like trying to do an echocardiography, write an ECG. There will be lectures about many topics as coronary artery disease, congenital heart disease which is much more common than most people think and also about heart failure and about their treatment options. There will be an exam to see how well you learned and what you know about this specialty. We will present cases that have a relevance and we think off as a great teaching opportunity ... Basically it's focused on a supportive educational environment with a focus on patient safety and the well-being of the student. Does that answer your question?"_

_Meredith nodded. _

_ But Meredith knew what to expect. This wasn't her first clinical rotation. When she attended the first one, she'd been overly nervous and scared even though she hasn't shown it. She's good at suppressing her emotions._

_Meredith was writing patient notes and she also did some research specifically aimed at writing those notes, as well as preparing to present during daily rounds. Duty hours also include didactic teaching sessions. He also gave them information about Duty Hours policy for third and fourth year med students. Duty hours must be limited to eighty hours per week, inclusive of all direct patient care activities. Meredith and the other med students were standing in a circle around the patient's bed. There was also a resident accompanying them. Name tag says her name is Dr. Anuj which sounded foreign, maybe she was from India.  
_

_ The patient was 67 year old man with ischemic cardiomyopathy. "Good morning, Mr. Eschersberg. How are you feeling?"  
_

_"I'm tired and I seem to be experiencing some shortness of breath." The elder man complained as he talked about his symptoms._

_"Well, in that case we have a few studies planned for today that will help us figure out the right approach to treat your cardiomyopathy." The doctor responded to his patient's question or better, statement._

_"Can anyone name me the causes of ischemic cardiomyopathy?" _

_He looked at each face. But it seems like all the others were clueless. Meredith breathed in deeply before raising her arm. She knew the answer and wanted to be good, wanted her supervisors and teachers to see how good she was and that medicine was her true calling and that she wasn't doing this out of obligation to someone or something. "You with the blonde ponytail …" Meredith was wearing a ponytail since it was more ideal at work. Apparently, their mentor still hasn't learned their names, which was to expect and not really surprising in a hospital that big and lot of staff – surgeons, physicians from other specialties, nursing staff, the people who work in the laboratory etc._

_"Ischemic cardiomyopathy is a type of dilated cardiomyopathy. It means the heart's ability to pump blood is decreased because the heart's the left ventricle is enlarged, dilated and weak. This is caused by ischemia - a lack of blood supply to the heart muscle caused by coronary artery disease and myocardial infarction." Meredith answered, carefully choosing her words._

_"Symptoms?"_

_"Symptoms of ischemic CM are shortness of breath, edema which means swelling of the legs, fatigue, inability to exercise, or carry out activities as usual, as well weight gain, cough and congestion related to fluid retention, dizziness or lightheadednes, abnormal heart rhythm due to arrhythmia, fainting caused by irregular heart rhythms, abnormal responses of the blood vessels during exercise, can happen without apparent cause as well as angina as in chest pain or pressure that occurs with exercise or physical activity and can also occur with rest or after meals and is a less common symptom."_

_After Meredith rattled down all the symptoms of ischemic CM, all the other med students were gazing at her in surprise._

_Surprised that one of them knew that much about this condition._

_"Does anybody know the risk factors? You." He was looking at Kaye, waiting for to answer. "I ... uh, risk factors ... are or can be family history, high blood pressure, smoking, diabetes, high blood cholesterol, and obesity." She finally stammered.  
_

_"Good."_

_"That's correct. Your name was Grey, right? It seems like you will become_ a_ great talent just like your mother." Meredith smiled lightly as he was praising her. But it wasn't really a big deal. Of course he knew her mother's name. Why wouldn't he know her name? This only outs a hell lot more pressure on her since her mother was basically a legend, a living legend with that. _

_Meredith called her mother after her first day of her clinical rotation. _

_"Anyone knows how to diagnose and treat it?"_

_"It's diagnosed based on medical history , physical exam, and other tests. Specific tests may include blood tests, electrocardiogram (ECG), chest X-ray, echocardiogram, exercise stress test, cardiac catheterization, CT scan, MRI scan, and radionuclide studies." Meredith started before going over to talk about treatment options.  
_

_She was full of newfound energy. She hadn't guessed that taking it after her mother and going into medicine was such a good thing. But honestly, it was. And she didn't do it because of her mother because that would be just wrong. Then she shouldn't do this. So much was clear.  
_

_ "The treatment of ischemic CM is aimed at treating coronary artery disease, improving cardiac function and reducing heart failure symptoms by taking a beta-blocker and ACE inhibitor even when not having symptoms. If symptoms occur and/or worsen, digoxin, diuretics, and aldosterone inhibitors may be added. Other medications will be added as needed, i. e. antiarrhythmic medication. Also a special diet might be advisable. There's also implantable Devices like cardiac resynchronization therapy (CRT, such as biventricular pacing) and implantable cardioverter Defibrillators for people at risk for life-threatening ventricular arrhythmias or sudden cardiac death. Both devices may be combined in a single unit, usually labeled CRT-D." Meredith really went into detail with her explanation even if it wasn't really necessary._

_The med students were able to be there when the patient had his exams. So they learned a lot about this specific condition. Meredith was writing notes to remember what she had learned today. The resident who was responsible for them, had explained a lot about how Cardio Imagining works and so on. It was very informative. Meredith tried not to hide in the back, she tried to take point when the senior resident asked one of them to try and perform a procedure on their own. She was especially looking forward to tomorrow since there will be a case study about CHDs. Mer and Kaye went home after resident dismissed them. Meredith had the genial ideal to get up even earlier to show up earlier than the others. _

_Because of a little something called pre-rounds. So she could review patient charts, physician notes to make a good appearance during rounds._

_Later, when they all were sitting in the auditorium, Meredith impatiently waited for the presentation to start. Then finally, the head of the department started to talk about the treatments of pediatric heart conditions. That was especially interesting for Meredith since she was affected by a pediatric heart condition.  
_

_He was presenting the case of a 14 year old boy who has Hypoplastic Left Heart Syndrome and has had three surgeries already and was now diagnosed with bradyarrhythmias and stenosis of the neoaorta that needs to be corrected surgically. __The Fontan procedure has more recently been used in pediatric situations where an infant only has a single effective ventricle, either due to lack of a heart valve (e.g. tricuspid or mitral atresia), an abnormality of the pumping ability of the heart. __It involves diverting the venous blood from the right atrium to the pulmonary arteries without passing through the morphologic right ventricle._

_/_

_She picked up the phone and called her mother's landline. But nobody answered, it appears that her mother was incommunicado at this point and time._

_Only the answering machine. _

_ Meredith didn't think much of it._

_ She figured her mother was in surgery and working on some gastroenterology problem that can only be fixed with surgery. _

_She then decided to order takeout food together with Kaye and studying for next day. Meredith had her book lay there openly. It was about pediatric heart conditions. It was originally designed for doctors specialized in that kind of thing but Mer didn't care. She liked that book. It was pretty detailed. But she doesn't want to specialize in pediatric cardiology. That would be way to personal for her liking.  
_

_She was looking forward to it. Kaye and Meredith were sitting on Meredith's bed and talked about what they saw and about their experiences. There was a little boy, one year old and undergoing cardiac surgery due to a heart defect. "I've known it to happen. I have been where the boy is now." Mer said, avoiding looking at Kaye. "I know, Mer. You're lucky that you are doing so well. I mean it was palliative surgery after all." Her friend added with a glance at Mer's chest. Meredith noticed that. "I know it was palliative surgery and not a corrective procedure." Meredith grabbed her laptop and searched for something in a medical database and recited loudly from an article about long-term morbidity and quality of life after surgical repair of TGA – atrial versus arterial switch operation. After that, they ate their takeout food. Kaye wanted to eat Asian food and Meredith agreed. _

_After taking a bite, Kaye asked with a full mouth: "Have you heard anything from Sadie?" Meredith cringed internally when she heard Sadie's name. _

_After their big fight in Europe, they kind of lost contact._

_ And it was okay, at least for Meredith because she had Kaye. "No I have not heard from her. Why should I have heard something from her? She's probably off somewhere travelling in Europe or something." Kaye rolled her eyes and answered: "Relax. I was just asking, no need to go all crazy on me." Later, when Kaye went back to her own room, Meredith called her mother again, hoping that she'd answer her phone this time. _

_But when she doesn't answer her landline, she called her mother's office and this time, Ellis Grey answered her phone after seeing that it was her daughter who called. _

_She hoped everything was okay and that her child wasn't calling because she needed medical intervention of problems that may have occurred over time. _

_She knew the odds and what could happen after an arterial switch surgery like loss of sinus rhythm, resulting in the desperate need of a pacemaker or other post-operative arrhythmias or baffle problems like leaks. She hoped that that wasn't the case. "Mom, are you there?" Meredith asked into the phone._

_ "Of course I am, Mer. Is everything okay?" She asked. _

_Meredith couldn't believe it. Her mother was acting caring, she cared about her. Even though she knew that her mother loved her it was something else than actually experiencing it. And now she was acting like a loving mother, it was rare but these rare moments were moments she'd never forget._

_ "Yeah, Mom, I'm good. I'm doing my clinical rotation on the cardiology ward of Hopkins. It's only four weeks but I think it'll be satisfying." She told her. _

_"Did you impress them?" Her mother asked. Meredith hummed. _

_But apparently, Ellis didn't seem to hear her. "Mer, I haven't heard what you just said." "Yeah, Mom, I think I did impress them. I was the only one knowing the physiology of various complex heart defects thanks to the medical book I got from you. You know there was this patient with dilative cardiomyopathy …" Ellis smiled sympathetically, knowing Meredith wouldn't be able to see her smile. Then Meredith told her mother about this specific case. "Mum, I … I need to ask you something." Meredith bit her lip, trying to win time. She doesn't want her mother to think that she was weak. She didn't want to be seen as weak. _

_"What if I am not good enough?" Ellis knew what the problem was, surely Meredith wasn't the only one having doubts about her performance. "You are. This is all new and stressful and there is a lot of pressure. Expectations are high, all the responsibility, I get it. I was there. Just remember that the two primary goals of clinical training are to learn to take care of patients and to develop your professional identity as a physician, don't let those doubts get in the way of your medical education. And, don't over-and underestimate your skills. Don't be scared, Meredith, you can do this." "Are you sure about that?" Meredith asked, the phone pressed against her ear. _

_"Yeah, Meredith I am sure of that." In that moment, Meredith heard her mother's pager beeping. Meredith sighed because she knew that her mother had to go back to work. _

_"Meredith, I …" But Meredith interrupted her mother. "I know you have to get back to work." "I have a … client." Ellis said, for a minute her voice shook. Meredith frowned. Client … Why was her mother referring to a patient as a client? That doesn't make any sense. "You mean you have a patient, Mom." _

_"Yeah, I have … a patient." Ellis Grey's voice sounded weird. Meredith noticed that immediately._

_ Something was going on._

_After the first week, the head of the department announced that there would be an exam near the end of the rotation. "So this means we have to study. Cardiology." Meredith stated after he finished. Kaye nodded acquiescently. "Plus, the preparing for the lectures every Monday." She added. They both went home at 7 PM. When they were back at their apartment, they ate a small meal before going back to studying the physiology of the heart and everything that comes with the territory._

* * *

When Meredith took a quick break in the interns' locker room she walked in on Izzie crying. Meredith stopped abruptly. Awkwardly, she stood there. She wasn't sure what to do. Something was going on.

She recalled scrubbing in with Dr. Burke and Cristina. She had been stuck managing the patient's pre-op care alone, completely alone. She still didn't know where the others had been. But she was sure that this and that was connected. Probably it was, is. This is Seattle Grace we're talking about. "Just LEAVE. This is all you …" Izzie screamed when she got aware of Meredith being in the room. But Meredith didn't budge. Silently, she sat down on one of the benches.

"Just leave me alone. Leave! Damnit, leave me alone." She repeated, her voice broke a bit. Meredith cringed. She wanted to be anywhere but here right now but her feet are like glued to floor or something. She just couldn't move even though she wanted to leave. Like she was a coward, only cowards would run.

It seems like she was one.

"Just get the hell out of here."

"What's going on? Why are you …" Meredith suddenly asked, not ending the question and not entirely sure if this is the right move but she feels like she has to do something which is more than just weird because she has no obligations to Izzie Stevens – both of them knew that for a fact. A small sniffle could be heard before the blonde doctor attempted to answer. "Why are you so nice to me after everything I have done to you?"

"Honestly?" Meredith asked, faking a laugh. "I have no idea either."

They both fell silent again. "I'm …" Izzie suddenly said.

"You're what?" Meredith asked as she turned her head to face Izzie who failed to look at her. She was obviously ashamed of something. "The Chief called in a meeting yesterday morning." "So that's where Cristina and Burke were headed. I knew there was something off about them meeting the Chief and all … anyways, I didn't know you had anything to do with that meeting." Meredith said surprised. She turned to open her locker and reached for a water bottle. She always has a reserve stashed in her locker. She didn't know anything about any meeting. It was like she hasn't even been informed. But maybe that explained Izzie's crappy mood. She was brooding over that said meeting.

"Oh, well, apparently, I had everything to do with this meeting." Izzie scoffed lightly. "What about it about?" Meredith asked, not knowing that she walked into a hornet's nest with that question. "Really, you are asking? You of all people should know what this was about." Izzie spit out, now she was like this Izzie Meredith had gotten to know over the months post-surgery.

"You probably even planned this to happen and you have the guts to tell me you haven't had anything to do with that? Screw you and your perfect little lives."

Meredith frowned at her roommate's outburst.

She has no idea what to think. Or what the meeting was about or anything related to meeting.

"First of all, you of all people should know that my life was not easy. It never has been easy. Second, I don't a damn thing about the meeting you're talking about. I never informed anyone about that beef between you and me because I didn't think I was important enough for them to be doing anything against it. I was a coward. Yeah, I was but only because I never said a word. And that's partly my fault, for the most part. I didn't think I was important enough for someone to actually care. But it turns out, they care. They care a lot. And you what? I am grateful for it, I am. Because chances are, my condition will deteriorate at some point in my life and it's good to know that I have a support system." Meredith breathed heavily, waiting for a reaction coming from Stevens.

"You see my life is everything but perfect. You had a good thing, Iz. You did. Why did you have to go and ruin everything? I considered you a friend. Somehow I always make the wrong choice. The same happened with Sadie. At some point she turned against me. But it wasn't because of my medical condition. It had other reasons, like her being a total ass."

Izzie said nothing.

Then ...

"Well, you don't need me. You have Cristina. You have Alex. You have Derek. You have everyone. Everyone cares about you."

"In fact, I have Cristina and have had her since I've been a kid." Meredith remembered suddenly memories from her childhood, memories she'd suppressed. But now she found Cristina again. Her best friend who moved to another city and was never to be seen again until Meredith started her internship. They both felt connected instantly and bonded. That is because they go way back … only none of them knew that until now. Cristina still doesn't know. But Meredith is going to tell her about her friend who suddenly moved, just to see if Cristina got the hint.

Maybe she would know what Meredith was talking about. Maybe ... maybe not ...

Fact is, they've known each other since early childhood.

"I don't understand." Izzie said. "You don't have to." Meredith shrugged. "I don't need you to understand it. I need Cristina to understand it, and Derek because they're my people and my family." Izzie nodded in understanding. "Well, to be fair I deserve this. I deserve all of this. I even deserve you hating me. I would hate myself had I seen what I was doing and what affect it was having on you."

"It's really nice that you realize that now." Meredith only answered.

Izzie packed her things before heading home, leaving a shocked Meredith behind.

* * *

After Meredith had done everything Bailey asked her to do, she went to find her superior. After some minutes she found her talking to some orderly about a patient concerning a post-op infection and changing some antibiotics. Meredith respectfully kept her distance. When Bailey finished her discussion and turned around she faced Meredith. "Grey?" She asked as she got view of her intern.

"You said you'd let me scrub in if I did everything you wanted me to do." Meredith reminded her.

"That would be too easy, Grey."

"I discharged every patient of yours that was ready to be discharged and you signed off on. I did all the charting? What other hoops do you to want me to jump through before you can consider letting me scrub in on your surgery?" Meredith asked, partly annoyed and trying very hard not to show it.

"A lot hoops, Grey." Dr. Bailey answered.

"I have heard you have been thinking about leaving this surgical programme to transfer to another hospital. Besides, you're still an intern until you get those results back, assuming you passed."

"Do you know who passed and who didn't?"

Meredith couldn't help but ask, she just needed to ask. Someone hasn't passed. Bailey's face clearly told her that. What if that someone is her? Probably it is. It's always her when it comes to those things.

"Let's hope so." Meredith answered, unsure if she had passed.

Maybe, maybe not – Meredith had no idea what to think now. With her luck she probably hasn't. Apparently, Bailey sensed what was going on inside her and was quick to reassure her. "Grey, this doesn't have to mean that I am talking about you. Stop thinking it's always you, Grey, I mean it." Bailey shot her a look. "I am sorry, Bailey." Meredith stammered, taken by surprise.

"Don't doubt yourself, Meredith." She addressed her intern by her first name. Meredith nodded without replying anything. "Are we clear on that, Grey?" She asked her. Meredith stuttered: "Yeah, we … we're clear." "Now that we have sorted that out, let's go see the patient. Come on, Grey." Bailey turned around and was headed for the patient room. It was at the end of the floor. Meredith quickly followed her superior. Bailey was now a fourth year. They entered the patient room after Bailey knocked. "Miranda Bailey! There you are and as I see you brought someone else. I guess she is here to learn isn't she?" Bailey smiled at the patient. "This is Dr. Grey, she will be assisting me today in the OR." Bailey explained her. Meredith was confused. Was the patient an old friend of Bailey's?

"Is she good? I am sorry to ask that but is she good?"

"You have nothing to worry about. Dr. Grey is one of the best first years soon to be second years we have. She will be explaining the procedure to you shortly while I want to do a quick exam before move you to pre-op. Had she gotten the required medication, Grey?"

"Yeah, Mrs. Heller has taken the sedative so she'll remain calm until we can get her into surgery." "I'm sorry, I know I have asked that question before, and you probably think I'm downright annoying but can you tell me once again why we're doing this surgery?" The patient asked, a nervous expression was now covering her face.

"Dr. Grey?" Meredith cleared her throat before attempting to answer the question

. "We will be performing something called a parathyroidectomy. It is the surgical removal of one or more parathyroid glands. The parathyroid glands are four rice-sized glands located on back of your thyroid gland in the neck. The parathyroid glands make parathyroid hormone also known as PTH, which controls the levels of calcium in the body. The parathyroid glands are primarily responsible for maintaining an acceptable calcium concentration in the blood."

"So that means PTH controls the calcium levels?" The woman asked, just wanting to understand what she was going to let them do on her. It was her right to be given information concerning the procedure she would be undergoing.

"Yeah, that's right. Of course we'll have to monitor your calcium levels every twelve hours after surgery until they stabilize."

"Why do the levels have to be monitored?" Mrs. Heller asked. "Post-surgery there is a chance of low blood calcium. There are parathyroid glands that lie behind your thyroid gland that help to control your blood calcium levels. If they are injured or removed during your operation, then your blood calcium can be too low and that could cause problems for you. Additionally it would require you to take calcium and vitamin D supplementation to balance your calcium blood levels."

The patient nodded after Meredith's elaboration. Meredith also looked shortly over the patient chart she was holding in her hands while talking to the patient.

"Why are we opting to removing them, Grey? What kind of condition does or patient have?"

"This patient has a condition called hyperparathyroidism. It means one or more parathyroid glands become enlarged and over-secrete PTH. This hormone is causing levels of calcium to rise in the blood and can cause hypercalcemia. The only definitive treatment for the disorder is surgery to remove the enlarged gland." Meredith explained without faltering. She knew her stuff.

"Dr. Bailey, wait." The patient called the general surgeon.

"I just need to make sure that you are aware of my medical history." Meredith turned around as well. "We know about your medical history and I will personally make sure that the anesthesiologist knows about that as well." Bailey smiled comfortingly at the woman who was reassured by the calm words of the lead surgeon on her case.

Meredith was already scrubbed in when Bailey entered the operating room. Meredith figured that there has been a holdup aof some kind. But that was okay. After at least five minutes of scrubbing in, the general surgeon entered the OR. Meredith and the anesthesiologist, the OR staff had been waiting patiently. They use accurate preoperative imaging studies and intraoperative parathyroid hormone measurement to monitor the patient's hormone levels.

"In 85-90% of patients with primary hyperparathyroidism occurs that, Grey?"

"That only one gland is abnormal." Meredith answered without looking away from the surgical field. "This allows us to perform a more limited, focused exploration where there is a high likelihood of having only a single abnormal gland." Bailey explained. Meredith was focused on the surgical area as Bailey resected the abnormal gland.

"Ah, there you are." She said. Meredith chuckled quietly at Miranda's exclamation but quieted down eventually when Bailey shot her a pointed look.

"Why are we doing this procedure the way we do it?"

Only the beeping of the cardiac monitor could be heard and the faint sounds of the vent pumping air into the patient's lungs.

"This approach is referred to as a minimally invasive parathyroidectomy or MIP and is the most common procedure performed today. The MIP procedure has a lot of advantages for the patient, like less post-operative pain, faster recovery from surgery, small or barely visible scar, shorter hospital stay and a more rapid return to work and normal activities."

"Excellent. Just like I told you, Grey. Don't always doubt yourself. You know more than you think you do. Don't underestimate your skills, it will only set you back." Miranda offered a piece of advice to Meredith. She wanted her interns to be successful and to make it as surgeons. But it's a long way to the finish line ... all of them knew that.

"With all due respect, that's easier said than actually done." Meredith replied, her eyes on the surgical field.

Intentionally avoiding Dr. Bailey's gaze.

* * *

**A/N: I'm really trying to manage updating this story and keeping up with my studies. Remember, I won't be updating regularly. Enjoy.  
**

**Hope you all had a good day. Please leave a review.**

**_(I may have accidently deleted a guest review. Keyword is accidently!)_**


	46. Chapter 46

**Chapter 46**

* * *

**No one believes that their life will turn out just kind of okay. We all think we are going to be great. And from the day we decide to be surgeons, we are filled with expectation. Expectations of the trails we will blaze, the people we will help, the difference we will make. Great expectations of who we will be, where we will go. And then we get there. We all think we're going to be great and we feel a little bit robbed when our expectations aren't met. But sometimes our expectations sell us short. Sometimes the expected simply pales in comparison to the unexpected. You got to wonder why we cling to our expectations, because the expected is just what keeps us steady. Standing. Still. The expected's just the beginning, the unexpected is what changes our lives. **Meredith Grey; Great Expectations

* * *

Burke had been reviewing the results of an preoperative catheterization and echocardiography which are important to provide hemodynamic and anatomic information. They need these results no matter what procedure and surgical technique that they are going to use for the cavopulmonary anastomosis. So he was very concentrated as he was reviewing the parameters. He was still worried, though. "Hey, what are you doing?" Someone appeared next to him, chewing on a power bar. He didn't even need to turn around, he knew that it was Cristina. He could feel that. "I am evaluating this echocardiography and the preoperative catherization of a patient." Some alarm was somewhere beeping but it turned out it was nothing. Soon, it was quiet again, at least as quiet as possible. This is a hospital, there is always somewhere some kind of commotion of any kind. "Is the patient emergent?" Cristina wanted to know, she was trying to catch a glance of what he's looking at. Burke was sitting on a chair, concentrated on staring at a heart in the four chamber view. Cristina was hovering and looking over his shoulder, interested in that particular picture.

"Burke, is there anything else I can do for you?" Cristina asked in a subtle tone. She leaned against the counter of the nurses' station and was monitoring an ECG from there in case the patient went into arrhythmias. The patient was a 67 year old male who just underwent surgery for mitral valve regurgitation due to Ehlers-Danlos Syndrome, a group of hereditary connective tissue disorders characterized by defects of the major structural protein in the body (collagen). Of course there can be other causes of mitral valve regurgitation, like there can be congenital causes or acquired causes like myocarditis that are from infectious diseases in nature. It needed to be corrected surgically because it was affecting him and the symptoms have gotten much worse over a specific period of time. But even if that was the case, he had a temporary pacemaker as a precaution in case that particular scenario happens in reality. Dr. Burke gazed as well at the monitor that showed a regular sinus rhythm. The monitor was beeping in a steady way and his blood pressure was in the normal level. He doesn't seem very concerned. "Have you finished all the labs and charts? Because I have a procedure scheduled. And I need to get there in time."

When he looked up, he saw the clock on the wall, ticking. Seconds, then minutes …

Nurses walked past them, pushing carts with a lot of medical supplies laying on them. But nobody of them seemed to notice. Dr. Preston Burke was thinking about the complicated procedure he was going to perform in a few minutes. The patient was only three months old and in the best shape that could be. This would be the second procedure for the little boy, followed by the third and hopefully final surgery but chances are that he might need follow-up surgeries or interventions, maybe an aortic valve replacement or a pacemaker implantation.

Cristina's face lit up like a Christmas tree on Christmas, not that she was really into Christmas, but her face lit up as soon as Dr. Burke mentioned a potential surgery she could scrub in on. And the cardiothoracic surgeon noticed that of course. Why wouldn't he notice? It was quite obvious that Cristina Yang was overly eager to scrub in on that surgery.

Cristina glanced at him. "Can I scrub in on that surgery?" She asked.

Dr. Burke cleared his throat before attempting the young, surgery-hungry intern.

"Uhm ..." He said.

"Bailey always says that surgeons don't say uhm." Cristina said in a frank way. Dr. Burke looked at her for a moment, frowning. "What is it that you are implying right now, Dr. Yang? Is there anything you'd like to share with me? Maybe the complicated thoughts of what's going on, maybe?"

"Nope, I'm all good. Thanks, though for asking." She simply replied. In that moment, the monitor went off and that ended the conversation between the intern and the attending. They had bigger things to worry about. "Cristina, I ..." But then a shrill beeping went off. Abruptly Burke broke off in the middle of the sentence and rushed into the room. He was followed by Cristina. Both doctors immediately recognized the abnormal heart rhythm on the monitor ECG. It seems like he went into an episode of SVT. "Looks like he has some kind of arrhythmia." Cristina noted the sudden changes as she started analyzing the patient's heart rhythm.

Burke didn't respond, he was busy studying the pathological changes in the patient's heart rhythm. "Yeah, I can see that, Yang. Now step back." Burke responded and took Cristina by surprise with that reaction. Cristina swallowed as she recognized the harsh tone in Burke's voice. "But I might be able to help ..."

"You can help by stepping back and letting me work." Cristina frowned at Burke's harsh voice.

But she didn't complain in any way. It would not help the patient in any way.

They have to control the heart rate to prevent hemodynamic collapse. If the patient is hypotensive or unstable, immediate cardioversion with sedation must be performed. Dr. Burke was administering IV adenosine. Then he watched the heart monitor for any changes. But the patient was still in supraventricular tachycardia. Dr. Burke turned to Cristina after waiting for the adenosine to start working.

"What do we do if the therapy with adenosine fails?"

Cristina answered darkly: "Medication like calcium channel blockers or beta-blockers that have an atrioventricular nodal blocking effect, and because of that they can be terminated by transiently blocking this conduction. Also, cardioversion is a very effective method for restoring sinus rhythm. Synchronized cardioversion is used immediately in patients who are hypotensive, are suffering from pulmonary edema, have chest pain with ischemia, or are otherwise unstable. If the patient is having more frequent episodes and medical therapy is failing, radiofrequency catheter ablation is another option."

And so they did what Cristina just said.

After they had the situation back under control, Cristina asked Burke about his changed attitude toward Cristina. She just couldn't understand why he was reacting the way he was reacting. "Burke." She said as he was writing something down in a patient chart. "Yes, Dr. Yang?" Burke asked in a professional manner. Cristina swallowed hardly. "Why are you treating me like this?" Cristina asked, for once feeling helpless.

"Why are you punishing me? Is there anything I have done wrong? Angered you in any way? Because, honestly, I don't know what I have done. So please, you've gotta tell me what is going on." She was pleading with him at the moment.

That made Burke look up. When he did that, she saw regret in his eyes for treating her like that.

He scanned Cristina quickly before resuming to his work, scribbling something down in the patient's chart. The surgery-hungry intern waited for him to reply to what she asked him.

"I'm ... I have to perform a surgery and I am not sure if I should, if it's the right choice. Someone really needs to raise awareness for this horrible disease." He said sighing. He had been dealing with a lot of pediatric heart disease lately, including _ACHD_-patients. "What horrible disease? Coronary heart disease or ..." Cristina asked, not exactly knowing what he meant with that. Burke looked at her for a moment. "I have to operate on a three month old baby with congenital heart disease and his state is deteriorating. The surgery was planned for Wednesday but now? I have to do it know because there is no way that this baby's heart can keep this up." "What kind of heart defect does the mentioned patient have?" Cristina asked, that immediately caught her attention. Ever since Meredith, she was more interested in the pediatric part of cardiothoracics, and that was partly Meredith's fault. She was the one who made her focus on that.

But hey, it was cardiothoracic surgery so she couldn't complain.

"It's Double Inlet Left Ventricle with Pulmonary Atresia, the hole is simply too small and the hole is between right and left ventricle is too small." "You mean the _Foramen bulbo-ventriculare_ is too small and the connection between ..." Burke only nodded and buried his head in his hands. These cases were always the hardest. Always. The pediatric cases were always the hardest.

Watching little kids, innocent little kids suffer like this, is cruel. That they were so small and so sick ... this wasn't fair. It just wasn't. This defect with additional defects like Pulmonary atresia cause severe obstruction to blood flow to the lungs or into the main circulation and may require urgent surgery which was performed at this hospital, three months ago after he was delivered via C-section. He sighed before he got up to get the patient ready for the surgery. When he entered pre-op 12645, the mother and the father were both there, the monitor ECG was beeping rhythmically. The mother was pacing. On the walls were pictures of animals in various colors since this was the pediatric floor. "Dr. Burke." He heard Arizona's voice greeting him from behind. "I'm taking him to surgery. He's been here since Tuesday and his sats have gotten worse. I have a solid surgical plan."

"Good. Page me if you need me." Arizona said as she smiled reassuringly at the parents.

"So what do you want to perform?"

"I want to perform something called a bi-directional Fontan or superior cavo pulmonary anastomosis, also referred to as Glenn or Hemifotan. After the surgery, half of the deoxygenated blood flows directly to the lungs without going through the ventricle. He may need another surgery depending on how well he responds to this surgery. Some kids with this defect are doing well without the final procedure."

"But this will help, right?" The mother asked, looking away from her baby's vulnerable body.

He seemed so small with all these tubes and wires coming out of him. And then there is the problem with gaining weight and the failure to thrive which is a common symptom in congenital heart defects.

"I can't make any promises. But I will do my best." Burke smiled at them in confidence. "Now I have to take him down to the operating room. I will have the nurses give you an update in one hour." The mother almost started to cry, she looked like she was about to, as she realized that she has to say goodbye to her baby for the duration of the surgery. They would stop his heart during the surgery. That seemed unbelievably scary. After they had taken their time to cuddle their baby before it being taken away to surgery, they were devastated. That was the hard part. Letting the child go and not knowing whether it will survive or not …

* * *

"Excellent. Just like I told you, Grey – you can do this. You have the skills and the brains. Don't always doubt yourself. You know more than you think you do. Don't underestimate your skills. It will only set you back." Miranda offered a piece of advice to Meredith. She wanted her interns to be successful and to make it as surgeons. But it's a long way to the finish line ... all of them knew that. "Take this advice from a skilled surgeon, Grey. Deep down, you know I am right." For a moment, only the continuous beeping of the cardiac monitor could be heard. Meredith had no idea of what to reply to Dr. Bailey.

Then, out of nowhere, Meredith replied. Dr. Bailey glanced up as soon as she heard the young surgeon's voice. "With all due respect, that's easier said than actually done." Meredith replied, her eyes on the surgical field.

Intentionally avoiding Dr. Bailey's gaze …

"You don't have to avoid looking at me, Dr. Grey. I'm not gonna bite you or anything, if that's what you think." Bailey suddenly said. Meredith gazed at her superior for a millisecond before diverting her focus back to the surgical field.

"Yeah, I know that." Meredith simply replied. "Seems like I got a newfound problems with ... whatever." She muttered under her breath. Bailey ignored that last sentence. Meredith watched Dr. Bailey working on the patient and soon they were about to close her up. "So we're almost through with the surgery. Would you like to finish?" "You're letting me finish, after you pointed out my all too obvious insecurities about being good enough to be a surgeon?" Meredith asked.

Meredith kept looking at the surgical field, not daring to Bailey in the eyes. Dr. Bailey sighed as she figured that Meredith wouldn't respond to her pep talk. So they worked in silence. It was only when Bailey wanted her to do something, she addressed her. Meredith was grateful for that. She had no idea that Cristina was sitting in the gallery, reading some medical book about cardiac surgical procedures and making notes on post-its, marking interesting pages. Meredith was focused on the surgery and the patient laying open on that table. "Grey, move a little more to your left." Bailey suddenly. Meredith quickly corrected the position and asked if it was now correct. The general surgeon nodded as she threw a glance at what Meredith was doing. "Is that okay like that?" Meredith asked, more confidence in her voice.

Cristina looked at the screen that the procedure displayed.

In that moment she was paged. It was Burke who was paging her for a consult. Apparently. In this moment, Meredith looked up and instantly recognized her friend standing there in the gallery, a big case book under her arm.

Cristina smiled at her reassuringly. Then Bailey said something to Meredith Cristina couldn't understand because the intercom was turned off. She hurried to pack her things and rushed to the OR where Burke started opening up the boy's chest.

She grabbed a surgical mask and entered the OR.

"You paged, Burke?" She then asked.

"Oh, you're here. Is there any way you can give me hand? I need it. I need someone who has experience with this kind of thing and you're the nearest person there is. So will you scrub in?" Burke asked as he looked up. He was putting the boy the boy on cardiopulmonary bypass right now, with the help of the perfusonist who was controlling the settings of the machine that has taken over heart and as well as lung function and temp regulation. Cristina didn't know what to say.

"Since you don't seem to want to scrub in, it's your turn, O'Malley. Gear up." Burke told him, ignoring Cristina's face expression before she left the OR again.

"I didn't say that."

* * *

_Izzie nodded in understanding. "Well, to be fair I deserve this. I deserve all of this. I even deserve you hating me. I would hate myself had I seen what I was doing and what affect it was having on you."_

_"It's really nice that you realize that now." Meredith only answered. "Oh, just leave me alone." Izzie shot back. "So one minute you are nice to me and the other you are just mean. What the hell is wrong with you?" Meredith asked as she watched Izzie ripping open her locker and packing her things. "Nothing is wrong with me. I'm going home." She answered without looking at Meredith. "Why are you going home?" Meredith inquired her as she watched Izzie packing her things. "It's none of your business." Izzie gazed at her for a moment before continuing to pack her things. _

_"You're right, it is none of my business. I'll give you that but what about the crap you pulled the other days? What about that? I mean, you hurt me by saying that." _

_"Oh, really I did?" Izzie didn't seem very surprised about it, as if it was intended to hurt her. "You did. What you said to me was disrespectful and I don't know what I have done to deserve to be treated like this. So, tell me what have I done to deserve this? Just tell me, I can take it." Meredith asked, furious. She wanted to know why. _

_Why Izzie had been treating her like crap all time … "You got every surgery." Izzie said. It was a lame excuse, they both knew it. In this moment, Meredith's pager beeped, signaling that she had some work to do.  
_

* * *

Meredith, Cristina, Alex, George and even Izzie were summoned in the intern's locker room. They were supposed to get their test results then. Meredith and Cristina sat on the bench, silent. They were just waiting in silence. Suddenly, Izzie asked: "When are we supposed to be getting the results?" Nobody really responded to Izzie Steven's question. They were all in their own world. "Hello? Anyone care to tell me why nobody's talking to me? Am I invisible or something?" Izzie wanted to know, annoyed by their behavior. Cristina finally turned her view at the blonde intern.

"You really got the guts to tell me what to do? Some of us may have forgiven you ..." She hissed at the blonde surgeon. "But I have not." Cristina added.

"Will you try to forgive me?"

"Don't know."

"I said I was sorry."

"Sometimes, actions speak louder than words." Cristina answered. After hearing that, Izzie stayed quiet. "Let's get this over with." Cristina murmured as Dr. Webber's assistant Patricia walked through the doors, carrying a stack of envelopes. Meredith's heart rate sped up at the sight. Now was the moment of truth. Has she really scored points or did she fail? She had no idea what to think. Her person noticed that Meredith was nervous about this, even though if Bailey told her to believe in herself.

"Moments of truth, people. Here are the results of the intern exam." Patricia announced.

Some other interns, who had other residents, stopped chatting as soon as Patricia entered the locker room and said that the results have been delivered. She started with the other interns.

"Those are our scores?" Alex asked as he saw Patricia entering the locker.

Meredith noticed that the others were chatting as they ripped open the envelopes as if there was no tomorrow. Meredith's nerves were lying on blank ice. She was incredibly nervous about her test scores.

Then she suddenly heard Cristina's name.

"Yang."

When Cristina heard her name she jumped up and grabbed her envelope, ripping it open instantly. "Grey, Karev, Stevens and O'Malley, here are the results-" She said their names. When Meredith grabbed her enveloped she didn't open it right away. She didn't want to, not like this anyways.

"Yes." Cristina exclaimed as she read over her test results. She passed. And she ranked 2nd. That was good but not the best she imagined. She wanted to rank 1st.

But apparently, someone else ranked 1st and not her. But then Meredith changed her mind about opening the letter. She only read the first lines. Then she breathed in deeply before a smile formed on her lips. "Have you passed?" Cristina asked, wanting to know how Mer did.

"You bet I have." Meredith smiled at her person.

Now that she knew that she has passed, made her feel relieved. It was a giant load off her mind.

Alex passed as well. He made a whooping noise as he finished reading it. "From the way you're acting I guess you passed." Cristina remarked. "Your observation skills are intact." He only replied. "I did pass."

But they didn't know about Izzie or George.

* * *

He waited for her to get changed from light blue scrubs, the kind of color interns wear, into street clothes. He was there and waiting for her to come. Meredith smiled at him, the envelope in her hand. She hasn't opened it yet. She wanted to open it together with him. "Hey you have your results yet?" Derek asked as he kissed her softly. Meredith chuckled while they were kissing. She was completely comfortable. "Yeah, I have opened it. I only know I passed but I let the ranking part out." "Because of your fear of failing, Mer, you really need to believe in yourself." Derek told her. "I mean you passed. This is great, Meredith. I've always believed that you would." Derek kissed her.

"Well, you've practically said the same as Bailey told me in the OR." Meredith said. "Minus the 'I'm proud of you part.'" She chuckled lightly.

"Oh, have I?"

Meredith nodded in reply. "But I'm glad that it's over now."

"But now that you have those results ... the other hospitals would like an answer and honestly, I do, too." Derek took a breath.

Meredith tensed instantly at the mention of that topic.

She had been avoiding this.

"Derek ..." She started but Derek quieted her.

"We'll talk about it tomorrow, is that okay with you?" He asked, and Meredith nodded in reply.

"Meredith, I have planned something, a thing." Derek suddenly confessed. "You have planned a thing?" Meredith asked, looking at him questioningly. What could that be? Meredith had no idea what it could be. "Yeah, I have." Derek smiled at her seducing. "But I am supposed to meet Cris and Alex at Joe's." Meredith protested halfway. Derek snorted. Of course Meredith would protest, he had known that from the beginning. But he wouldn't have that. "Cristina and all the others are there too. This is supposed to take your mind off the intern test scores." Derek told her. Meredith stopped and put her hands on Derek's chest. She didn't care if others saw her. Then she was kissing him softly. He embraced her and put his head in the crook of her neck. For a moment, they just enjoyed the moment.

"I love you, Derek. You know that, right?" Meredith mumbled softly.

"Let's go." Derek loosened his arms around Meredith who looked at him with her eyes. Directly into Derek's mesmerizing sparkling blue eyes ... God, she loved those eyes. Then they both walked down the hallway and they were soon leaving the hospital. Then, only minutes later they were meeting all the other new residents and even Mark, Arizona and Callie.

Meredith was surprised. "I thought this was only for interns?" She asked as she turned to look at Derek for a moment. "Oh, come on, Mer. You've made it through intern year. Let's celebrate that. It's a milestone, I know there are many to come but for now just let us enjoy this. Look, there is even beer."

"Beer?" Meredith said in reply. "What is wrong with beer?"

Meredith, Cristina, Alex, Mark, Callie, Arizona, and Derek were on the baseball court. Cristina wants to go back to the hospital and Meredith agreed with Derek when she heard what Cristina was saying.

"Oh come on, I have no time for games." Cristina grumbled, thinking about getting back to the hospital instead of standing here in the cold. It was freezing. Okay, maybe she was exaggerating. But she sure as hell didn't wanna hit any balls that are flying into her face. Meredith saw this in another way. She was more relaxed than Cristina. "Cristina. We got through our internship. There are now only the three years of residency left before we have to take our oral boards." Meredith said back. Cristina looked at her. "Well, you seem pretty confident that you'll make it 'til there."

Silence was lingering over the group.

Everyone standing there fell silent. In that same moment, Cristina knew how that sounded. And she was ashamed of herself for even thinking of saying it. But she said it.

"I'm sorry, Mer. That comment wasn't appropriate." Cristina sighed.

"You're right it wasn't." Derek added in a serious voice as he instinctively reached for Meredith to reassure himself that she was still there. Apparently, this was a sore point for all of them. After all what they've been through with ... "Derek, it is okay. I'm here." She said soothingly, knowing Cristina's words have had an impact on him. She knew that just by looking at him.

Derek said they're not going to talk about the hospital: "But we are not talking about the hospital. Not everything is about the hospital, nor should it be. Too much of our lives involve being in the hospital as doctors, for the most part at least." He shot Meredith a glance. Everything noticed it. Callie grabbed a beer for and one for Arizona. They were both standing a few meters away from the others to have their privacy. "We basically already live there. And now we can enjoy some time outside the hospital. Without having to worry about any patients, procedures or surgeries ..."

"... especially heart surgeries since some of us seem to have a thing for that." Someone commented.

Meredith snorted. "Hah, hah … it is not funny." Meredith exclaimed in exasperation as she heard that. "Fine, now that we've established that we came here to hit some baseballs - now that sounds like it could be fun, right - we are gonna do that." Derek said loud enough for everyone to hear that. After all, they're here to play baseball.

"We're here to play baseball and drink beer." Mark interjected, holding up his beer bottle. Meredith laughed at him. "I'm sorry but I'm leaving." Cristina suddenly said.

"Burke's got this super interesting surgery. He is operating on a three month old who was born with DILV." Cristina told them. "Double Inlet Left Ventricle, also known as a single ventricle defect." Meredith nodded knowingly. "These are highly complex." She said.

"Depressing." Mark mumbled. Meredith hit his arm in reply.

"Way to go, Mer." Derek laughed.

"I could have scrubbed in but instead I am here, supposed to play baseball." She was grumbling to herself. "I'm leaving to go watch the surgery in the gallery." "You won't. You will stay." Meredith had a determined face expression covering her face.

Cristina tried to leave, but Meredith stopped her. "Cristina, you stay." Meredith said in a confident voice. She walked over to Derek, told him to hand her helmet and the bat and walked over to Cristina.

"Come with me." She said with a voice Cristina couldn't do anything against. "You stay here." She put a helmet on her person's head. "This is for your head because even if I have a genius neurosurgeon fiancé, I don't want you to end up at the hospital with a traumatic brain injury. We've spent enough time there as patients. No need for adding other medical emergencies if you know what I mean …" She gives her the bat and tells her to hit the ball.

"Oh yeah, I know what you mean." Cristina huffed in reply.

"Now hit the ball." Meredith motioned to Derek who got ready to press the button. "And drink your beer." That was coming from Mark. "What more do you want in life?" Derek added.

"I don't want to." Cristina said annoyed.

She told her: "Stop worrying about what's gonna come, and focus on what's right in front of you, like this ball." The second after Mer said that, the machine shoots another ball at her.

"What the hell?" Cristina exclaimed loudly as she was totally unprepared.

"Just focus on the ball." Alex added as he took a sip of his beer. Derek smiled. Meredith seemed to have her fun.

Then he hits the button again and another ball comes out of the machine and this time …

She hit it.

"I hit it, I hit it, I hit, I hit it ..."

"You did." Meredith grinned widely. She was happy for her friend.

They all cheer loudly. Cristina handed the bat over to Derek and hugged Meredith. They were both laughing happily. After Cristina finished hugging Meredith, Meredith took the bat out of Derek's hands and said: "Let me try. I wanna try." She took Cristina's place and hit a ball as well.

She smiled widely. Derek was walking over to her and kissed her on the cheek. "Wanna do it again?" Meredith nodded enthusiastically. They were having fun out there …

It was getting darker, and they were the only ones out there this late.

Of course they were the only ones.

At that moment a sharp, fresh breeze of wind brushed through Meredith's hair, causing her teeth to clatter. Of course Derek noticed that instantly. He seemed to have this weird antenna thing for those things. Are you okay, seemed his blue eyes to ask. He was concerned about Meredith's well-being. She looked at him, wanting to tell him that she was okay.

This is the normal reaction of someone who's standing somewhere cold (at least, for some people and apparently, she was one of them.) Derek got what she wanted to tell him just by looking at her.

"Beer?" Meredith asked, scrunching her nose. "I don't want beer. Don't you have by any chance any tequila?" Meredith couldn't help but ask. Cristina broke down laughing. "This is so Mer." She said. "Duh, everyone can hear you giggling like a schoolgirl." Meredith noted to make Cristina stop doing that. "Relax, Grey. Just relax." Alex intervened, Meredith shot him a look.

"He's right, Grey. We're just here to have some fun."

"Mark!" Derek gritted out. "Relax, if I wanted to hit on her I'd do that differently." The neurosurgeon only scoffed in reply. "Good to know."

"Come on, Meredith, now it's your turn." Cristina called out as she took a big sip of her beer. Meredith watched her friend amusedly.

Then Derek got called into the hospital with a page saying it was urgent. Meredith looked at him questioningly as she saw him scanning the pager that was telling him to get his ass into the hospital. But it wasn't because of a patient. But he wouldn't tell Meredith why he needs to get to Seattle Grace Hospital right away.

* * *

**A/N: Hey, there. Thank you for reading this.**

**Some of you may have wondered what a Double Inlet Left Ventricle is. Well, here's the answer. Double Inlet Left Ventricle (abbreviation: DILV) is also called Single Ventricle. This is one of a group of very complex defects where both Atriums connect to the same ventricle and/or one ventricle is absent or very tiny. In most cases the infant develops symptoms in the early weeks of life - either with cyanosis or with breathlessness and failure to gain weight normally. Many affected patients have associated defects in the heart or main arteries, including such problems as Pulmonary Stenosis, Pulmonary Atresia, other valve abnormalities or Coarctation of the Aorta, etc. Such problems may cause severe obstruction to blood flow to the lungs or into the main circulation and may require urgent surgery. **

**Treatment is aimed at repairing the associated problems, where that can be done and performing staged surgery to make the heart work effectively. There are often several surgeries being needed, at least three. The first is depends on what symptoms the baby is showing / what the anatomy is e.g. Damus-Kaye-Stansel Operation or an aorto-pulmonary shunt, followed by the bi-directional Glenn-Anastomosis also known as Hemifontan. For many children the final operation is called the _Fontan Operation_ which comes after the Hemifontan procedure. After the completing the Fontan procedure, the blood is rerouted. It gets not pumped back to the lungs by the heart. Instead, there is a connection between the vena cava superior and inferior and the blood flows to the lungs without the help of the heart. This leads to blue blood being channeled through the lungs, without any 'pump' driving it. But that means that the pulmonary resistance has to be low in order for this to function. The large, left ventricle then pumps the oxygenated blood through the body. These surgeries do not correct the underlying defect. This condition is not curable. The Fontan procedure is a palliative procedure, meaning it is performed to give the kid a shot at life. Not all children with that kind of defect need to have a Fontan operation.  
**

**Supraventricular tachycardias (SVT) involve reentrant pathways with a component above the bifurcation of the His bundle. Patients have sudden episodes of palpitations that begin and terminate abruptly; some have dyspnea or chest discomfort. Diagnosis is clinical and by ECG. Treatment is with vagotonic maneuvers and, if they are ineffective, with IV adenosine or nondihydropyridine calcium channel blockers for narrow QRS rhythms or for wide QRS rhythms known to be a reentrant SVT with aberrant conduction that requires atrioventricular nodal conduction, procainamide or amiodarone for other wide QRS rhythms, or synchronized cardioversion for all cases.  
**

**_So I actually was able to post this chapter on my birthday although as of lately, it has been very stressful with school and homework and studying for exams ... _**

**_Please review ..._**


	47. Chapter 47

**Chapter 47**

* * *

**The body has approximately eleven organ systems, all doing different things at the same time. In order to keep us functioning, or, well, alive, they need one voice, a leader, a master. And in our brains, that job belongs to the pituitary gland. It sense the body's needs before they even arise, working non-stop. The pituitary gland communicates with all of the other glands, telling them when to produce the vital hormones we need to function. It keeps everything running smoothly, in perfect order. There's no denying it. It has the toughest job in the place. It's pretty simple. If the brain's working, the body will listen. Your limbs want to hold you up. Your lungs want to breathe. Your heart wants to beat. But none of them are any good without the brain. The brain keeps everything all together. Like a boss.** Meredith Grey; Walking Tall

* * *

Then Derek got called into the hospital with a page saying it was urgent. When his pager shrieked loudly, Meredith turned her attention to him. "Do you need to go?" She asked, well aware of what his answer would be. Derek quietly read what the pager said and then turned to Meredith. She looked at him questioningly. "Do you?" He nodded. "Yeah, I do have to go. I'm sorry, I know you've wanted to spend this time together but … I got to deal with this situation." He gave her quick kiss on the cheek before turning to leave the baseball field. All the others had stopped playing and watched the scene unfold. "What kind of situation?" Meredith asked bewildered, afraid that there was something he wasn't mentioning, intentionally. "There is something I need to deal with." Derek said, sighing. The pager was telling him to get his ass to the hospital. But it wasn't because of a patient. It had other reasons, different reasons. They both knew it but nobody wanted to admit it. He knew he'd have to tell Meredith sooner rather than later but for now he wanted to keep it quiet as long as possible.

"Hey, Shepherd, you already have to go?" Alex called over as he realized that Derek was leaving.

"I do, there are some unexpected things I need to take care off." Then the neurosurgeon glanced over to Meredith. "I'll call you as soon as I can, Mer." He said as an excuse. Meredith just replied with: "It's okay." Derek threw one last glance at the others and then back to Meredith before he turned around reluctantly to walk to his car and get behind the wheel.

Meredith watched him go. An uneasy feeling crept up in her. She couldn't place it.

"Come on, Mer. Let's play." Cristina called from far away but Meredit's thoughts were elsewhere. She had no idea why Derek was being so secretive but she was positive that it was unlikely to be good. "Really, I don't really ..." Meredith started to say. "Oh, come on, Mer." Cristina called back. "Just because Derek is paged, it doesn't have to mean that the fun is over. Here, have a beer and relax." Cristina told her. She reached for a bottle and passed it over to Meredith.

She reluctantly took it. "But ..." Meredith protested. "Don't go all mopey face on me, Mer."

* * *

When Derek Shepherd arrived at the hospital he walked across the lobby to get to the elevators. He pressed the button to get the elevator to get down here. But before he could enter the elevator, a voice called his name. "Derek. Derek Christopher Shepherd, there you are. The nurses were so nice to have you paged." He knew that voice. Derek instantly turned around and was looking in the face of his mother and his sisters, all four of them, actually. Meredith wouldn't like this one bit when she became aware of the situation. "Mom, what are you doing here?" "I want to meet your fiancé. You're like a dog hiding a bone around her. So I want to meet her." Carolyn Shepherd glanced at her son, scanning him. "Yeah, I could have guessed that." Derek said, taken by surprise. "But you could have at least show some courtesy and call me before getting on a plane and fly over." Derek said. His mother looked at him attentively.

"For crying out loud, we're your family." Nancy interjected, bitchy and moody. Derek ignored her.

"You look tired and stressed." Carolyn said as she embraced her only son.

"I missed you." She then confessed. Damn it, he did too but why did they come here so suddenly? He didn't have had any time to prepare Meredith for it. Damn it. Meredith. How was he going to tell her without her freaking out the minute he did so. "I did too but what are you ..."

"We're visiting." Kathleen said.

"What is going on here?" Damn it, he should have known that his mother could sense these things. He sighed and averted the glance from his mother. Instantly, Carolyn knew something big was up. Most likely it has to do something with Meredith, at least that's what she guessed. And probably, she was right in assuming this. "It's been a long and horrible months. Meredith and I have been through a lot, especially she has been through a lot. But that's all I'm going to say because it's a private concern." Derek avoided jumping deeper into the topic. "It's a private concern? Did you … You didn't knock her up did you?" "Amelia." Carolyn scolded her youngest daughter. "Behave." Amelia rolled her eyes.

"Yes, mother." Amelia relented. Derek was shocked.

"Amy, what are you doing here?" "Is it forbidden to visit my big brother who's always been there for me when I needed him to be there for me? I miss you, Derek. I miss having you in my life."

"Let it go, Amy." Derek gruffly replied, avoiding looking at his sister.

Amelia groaned.

She knew her brother was stubborn but dismissive?

It is years ago since that particular event happened that made their interaction this awkward. Amelia sighed. She really wanted her big, overprotective brother back. The real him …

But she was also looking forward to meeting this Meredith person. But she wasn't gonna judge until after she met her. That's where she was different from Nancy. She knew her sister was judge-y. She experienced it herself. For now, Amelia was letting this topic concerning her and Derek go but she knew they would have to talk about it at some point. They might all well do it now.

"Okay, before you will meet her you have to promise me something. Promise me."

He looked at Nancy before diverting his glance back to his mother. "Don't treat her like she's not good enough …" He glanced at Nancy. "… nor is she slutty. She's funny and a great doctor with good instincts. All I am asking for you to is to give her a chance. Don't write her off until you get to know her."

"But what about when she broke your marriage?" Nancy couldn't help but ask.

"My marriage was broken before Meredith came into the picture. So stop it; Nancy. I know you love Addie but Mere is the love of my life." Derek sighed as he was trying to convince his family. "So when can we meet her?" Amelia butted in. "After I prepared her for this. You can be a little too …"

"A little too what?" Nancy asked, eyeing her brother, saving Derek from having to answer Nancy's question. But Derek knew she could be a little persistent. In this moment, Addison walked across the lobby.

Derek groaned.

Talk about awkward. Why was it always him who got dragged into those situations? He did not understand this one bit. "Addison?" Nancy exclaimed as she walked over to her, arms stretched out. "Nancy, is that you?" Addison seemed surprised as well, pleasantly surprised. It's been so long since they had seen each other. "Yeah, of course it is. I came to check out that intern, you what's her name? I mean she didn't even accompany Derek to the hospital." Addison had no idea what to reply. But Derek wasn't shy to reply. "You have absolutely no idea what you are talking about, Nancy. I didn't tell her that I was going to the hospital to meet you. I kept it from her. She thinks I am here because of a patient."

"Why are you keeping her away from us?" Lizzie asked. "You always say that we're difficult and scary and all ... is it that?"

"Yes." Derek told her frankly.

"She didn't grew up as we did. There were significant difference between her and my childhood." "So

"I want to meet her. You are going to marry her. It's just comprehensible that we want to meet her." Derek knew Lizzie was right. He knew that but he also knew how Meredith would react to this kind of news. "You are wolves, blood-sucking vultures." "Did you just compare your sisters to wolves?" Carolyn scolded. Amelia held back a laugher. Derek was right. Her sisters were indeed wolves. In this moment, he was noticing his pager chiming again. He was annoyed. He had one evening off and is going to spend it at the hospital dealing with patients and his family. This is just great. Amelia noticed that.

"Are they paging you?"

Amelia asked, she knew the drill, she was a neurosurg fellow and knew how it worked. Derek glanced at his pager before attempting to answer Amelia's question.

"They are, indeed. There's something about someone needing an emergency neuro consult in pediatrics so I've gotta run." "Well, go. You've gotta go to work. This is more important than keeping us company." Amelia told him. In that moment, Derek was glad that she was his sister even if he didn't show her that that often. Derek excused himself quickly before turning around and running toward the elevator.

"Hold that elevator." He called as the doors closed. He saw two important-looking men in suits in the elevator.

"Hold it." Derek repeated, loudly. He gasped when he was in the elevator, and catching his breath again. The two men were watching him, probably seeing a distraught, sleep—deprived and stressed doctor in front of them. But Derek didn't have the time to care nor did he want to care about that. He pressed the button to the surgical floor. But the men wanted to human resources and told him that. "We were going to HR." One protested.

"Well, I am the Head of neurosurgery and I have a medical emergency, meaning a life and death situation, on my hands. If your problem isn't so dire that it's more important than patient care and responding in medical emergencies, then …" Derek put them to their senses. And they finally seemed to understand what Derek was talking about.

"Ok, ok, we understand that your situation is more dire than ours. We're deeply sorry for causing that inconvenience."

"You better be." Derek muttered under his breath.

Then the elevator doors opened and Derek sprinted over the hallways while his pager beeped for the second time with barely any time to spare. "Damn it." He screeched loudly as he entered the PEDS wing. "Get out of the way!" He called as he ran toward the patient room. A few nurses jumped aside quickly at the sight of Derek. When he reached the patient room, Arizona Robbins was already there, waiting for him. "What happened?" In his mind he went over the things that could have happened. "We may need to push up the surgery." Arizona told him.

He looked around the room. It was darker, and not really illuminated. "So we do the surgery tomorrow. I'll put it on the OR rotation for tomorrow." Derek said after making sure his patient was stable. She was.

But Arizona felt like it was neccessary to move it up.

"So you're going to do it tomorrow?" Both parents asked the same question at the same time. Derek nodded.

* * *

_Out of blue, Derek heard footsteps nearing them. "Dr. Shepherd." The voice asked. "I need to ask you for a favor. I want your opinion on this brain tumor." Derek turned around and looked into the friendly face of his colleague, in front of him was Krychek, one of three senior neurosurgeons of Seattle Grace Hospital next to Weller and Nelson. "You need a consult?" Derek asked, turning away from the OR rotation, motioning Krychek to walk with him. "Yeah, we need a consult. We still haven't determined whether it's a solid tumor or a cyst." Derek nodded to signal that he was indeed listening to what his colleague says.  
_

_Yeah, I'd be very happy to work with you on this Craniopharyngioma." The elder neurosurgeon said, wanting to flatter Derek so he'd say yes to consult on this patient. Derek flashed a smile to his colleague._

_Derek suppressed a sigh but however, he liked to consult on interesting cases._

_But he had a meningioma resection scheduled later today. He just hoped this would not interfere with his schedule. And a consult on a patient with a Craniopharyngioma, a tumor that __occurs at the base of the brain, above the pituitary gland - that'd be way more interesting than a simple aneurysm repair. "You want me to consult in a patient with Craniopharyngioma? Can you give me a brief patient history, please? I would also like to see the most recent scans and if possible to labs 'cause this tumor affects the endocinology." Derek was now all in doctor-mode. "Yeah, of course." Derek smiled curtly.  
_

_"This way, Dr. Shepherd." His colleague said as he walked toward the next viewing room._

_Derek followed him. His gaze went over to the films instantly. He was looking at a human brain._

_"What are the symptoms? Any headaches, mood swings or behavior changes, confusion, weight change, drowsiness or fatigue, nausea or changes in vision? __Pituitary insufficiency, adrenal insufficiency, or any other symptoms that are related to that kind of tumor?" Derek asked with interest in his voice.  
_

_"Patient is seven year old Brianna Davidson." The surgeon started, only to be interrupted by Derek._

_"The patient's a kid? This is a pediatric case? Who is the PEDS surgeon on this case?" Derek asked as he stepped nearer to look at the images. "That would be me." Arizona's voice sounded through the room as the blonde pediatric doctor stepped into the room. Derek turned around only to be facing Arizona Robbins._

_"Brianna Davidson was admitted under my care so I am the one scrubbing in on this one. When do you want to operate?" She asked, she was all business now. Derek turned to the pediatric PEDS surgeon was now looking at the pain films as well._

_"Well, we were discussing tactics." Derek said tentatively, they were figuring out which approach is the best. He turned his gaze back at the films, studying them attentively. "Since this tumor's benign, it's elective so we can schedule it for later this week." Derek decided. "Now, I need to know the patient history." He repeated. "Brianna was admitted last week showing symptoms of hydrocephalus due to increase of ICP, bi-temporal hemianopsy and visual changes." "I also would order blood and urine tests to measure hormone levels and we may need to schedule a consult with an endocrinologist." Derek then added. "We'll page endocrinology and have them assess the patient, additionally I'd like to schedule an MRI of the area surrounding the pituitary gland." "Sounds reasonable to me." Arizona Robbins approved of his plan._

_"Depending on the type of the tumor we may wanna look into different treatment options like orbitozygomatic craniotomy, radiosurgery or stereotactic radiotherapy, or hormonal replacement therapy. Maybe it's even possible to remove the tumor using the endonasal approach." Krychek said, pointing toward the films. "Let's just wait for the results."_

_"Let me talk to the parents when we have a concrete treatment plan." Arizona said. Derek nodded at that.  
_

_"I will accompany you since I will be the lead neurosurgeon on the case. It's only good to know that their daughter is in good hands." Arizona chuckled. "Because they've got me as their surgeon." Okay, now Derek's ego played into it. Arizona shook her head as she saw Derek smile. "Now I know why they you McDreamy."_

_"What?" Derek asked, taken by surprise._

* * *

Later that evening, Meredith sat on their bed, her telephone in her hands and waited for Derek to call her back. She'd left him numerous messages since he left after the baseball-thing. It wasn't that she didn't trust him it was just that she knew that something was going on. Maybe he was with a patient and maybe it was something else, Meredith had no idea. Then suddenly, a text message popped up on the screen. Meredith clicked at it to be able to read it. It was from Derek. Then she started reading it. She was happy that he hasn't forgotten about her.

_Hey, Mere._

_ I'm so sorry I left so abruptly._  
_That was never planned to be like this, so_  
_I hope this won't be a problem. I'm at the hospital._

_I was called away to an PEDS emergency. _

_And there is something else you need to know._  
_Please come to the hospital now; Mer._

_I have to talk to you._  
_Love you always, Derek._

So Meredith got up from the bed, packed her things and was soon on her way to the hospital. When she parked her car in the parking lot, she felt nervous.

Although there weren't really any reasons to be.

At least no reasons she was aware off. She had no idea that Derek's family was currently in Seattle and visiting. She walked straight to the elevator and pressed the number of the surgical floor where she presumed that Derek was. She was totally unaware of a person with grey-ish glancing at her for a momet, and coming to the conclusion that this was Meredith Grey. Meredith didn't know any of that.

Then Meredith got off the elevator and soon found Derek at the nurses' station writing charts.

"Hey." She smiled.

Derek turned around as he heard her voice and a smile formed on his face. He was happy to see her. "Hey, you can't seem to be without me." He mocked.

Meredith did not reply. Instead, she ...

"Hey that was uncalled for." Derek called out as Meredith hit him slightly on the arm.

Then he got serious again.

"Meredith. I have to talk to you." He gulped, also he was acting weird. He pulled her to an on-call room and closed the door behind them. He was avoiding to look at her, something he rarely does. Meredith looked at him attentively. This doesn't sound as if it were good news.

"Ok." Meredith said slowly, not exactly knowing what to expect now but she guessed that it couldn't mean anything good.

"So what did you do?" Meredith added bluntly causing Derek blush. This was his Meredith. "What makes you think that I did something? Okay, to be fair, you are right." Derek quickly added. He had no idea that his family would suddenly turn up at the hospital with absolutely no warning or call at all. He never expected this. "Just tell me what's going on." Meredith pressed for information.

"My family is here." Derek waited for her reaction. Seconds later, Meredith still hasn't said anything. So Derek was getting a bit concerned about her.

"Mer." Derek asked. "What?" Meredith asked, barely audible.

"They're here. I had no idea that they were planning this. I honestly had no idea. I swear." Meredith breathed in deeply, trying to shake off the upcoming panic that was coming along at the possible prospect of having to meet Derek's family. She wasn't ready for this. "All of them, are all of them here?" Derek nodded only.

Meredith closed her eyes for a moment, wishing herself far, far away.

"All four of them … and your mother …?" Meredith exclaimed in utter surprise. She was shocked at how distorted her voice actually sounded. "Yes, all of them are here. If I had known that they were planning to …."

"But you didn't." That was a statement.

Meredith sighed. Her horror imagination had come true and that so suddenly with absolutely no warning at all. This was not fair. "Ok, how much ground do I have to make up?" Derek looked at her like he didn't what she wanted from him. "What are you saying, Mer?" Derek asked, frowning. Knowing himself that it wasn't fair to drop a bombshell like that on her and expect her to be okay afterwards. "How much do they hate me already?" Meredith asked, resignedly. Derek shook his head. "We went over this already, Mer."

"So what?"

"They are gonna hate me instantly." Meredith tried to tell him, wanting to make him understand how she feels and why she feels that way.

"This is not going to be as bad as you think it will be." Derek reassured her, hoping he'd be right and not a complete liar.

"They will love you Mer. They just wanna meet you, my future wife. And I want you to meet them so you can have an actual family."

"You are my family. And Cristina, Alex ... You are my family, Derek." Meredith replied.

He knew how bitchy Nancy could be to someone who wasn't *fitting* in. She still considered Addison as her right sister in law even though Derek and Addison were divorced by now. "Come here." He stretched out his arms and Meredith immediately got the hint. He enveloped her with his arms. Soon, she was in Derek's arms and breathing in his scent. For a moment, she forgot about the McFamily visiting. For a moment, everything was normal, about as normal as it could possibly get. "I love this. More of this I say." She mumbled quietly. Derek grinned. He had known that this would calm her down.

And it really has been successful.

"I love you, Mer. You know that right?" Derek said quietly. They didn't say them very often.

Meredith smiled even though she knew Derek wouldn't be able to see this. She did too. She snuggled into Derek and so they stayed for a moment.


	48. Chapter 48

**Chapter 48**

* * *

** To make it - really make it - as a surgeon - it takes major commitment. We have to be willing to pick up that scalpel and make a cut that may or may not do more damage than good. It's all about being committed, because if we're not we have no business picking up that scalpel in the first place. There are times when even the best of us have trouble with commitment, and we may be surprised at the commitments we're willing to let slip out of our grasp. Commitments are complicated. We may surprise ourselves by the commitments we're willing to make. True commitment, takes effort, and sacrifice. Which is why sometimes, we have to learn the hard way, to choose our commitments very carefully.** Let The Angels Commit

* * *

"Ok." Meredith said slowly, not exactly knowing what to expect now but she guessed that it couldn't mean anything good. "So what did you do?" Meredith added bluntly causing Derek blush. This was his Meredith. "What makes you think that I did something? Okay, to be fair, you are right." Derek quickly added. He had no idea that his family would suddenly turn up at the hospital with absolutely no warning or call at all. He never expected this. "Just tell me what's going on." Meredith pressed for information. "My family is here." Derek waited for her reaction. Seconds later, Meredith still hasn't said anything. So Derek was getting a bit concerned about her. "Mer." Derek asked. "What?" Meredith asked, barely audible. "They're here. I had no idea that they were planning this. I honestly had no idea. I swear." Meredith breathed in deeply, trying to shake off the upcoming panic that was coming along at the possible prospect of having to meet Derek's family. She wasn't ready for this.

"All of them, are all of them here?"

Meredith hoped he that he wouldn't confirm her fears but then, eventually, he did.

Derek nodded.

And making her break out in panic with that, even if only on the inside. She excelled in controlling her emotions. Meredith closed her eyes for a moment, wishing herself far, far away. On the outside, she stayed calm.

"All four of them … and your mother …? They are all here? In Seattle?" Meredith exclaimed in utter surprise. She was shocked at how distorted her voice actually sounded. "Yes, all of them are here. If I had known that they were planning to …" Derek had feared that Meredith would react like that. He'd been surprised as well when they showed up suddenly.

"But you didn't." That was a statement.

"If I had known, I'd warned you earlier." Derek ran his hands through his hair in a distressed mode.

This whole situation was stressing him out as well.

Sure, he was happy about them coming to Seattle and visiting him but they could have had the courtesy to call and let him know that they were about to board a flight to Seattle. But they didn't and that put him in this situation. Meredith looked like she wanted to run. "Meredith." Derek said. Meredith looked up at the sound of his voice and immediately, her thoughts about a certain topic disappeared. "I'm not running. Promise." She replied.

"Good. Because I can't exist without you. You're my everything."

"You can."

"But I don't want to, I don't ever want to ..."

"I mean it's always been you." Derek said, dreamily. Meredith smiled warmly.

But soon her focus was back on the fact that McDreamy's family was in Seattle and that they wanna meet her, Meredith Grey, child of the dark and twisties ... that was the recipe for a disaster.

"Let me guess they are here to meet me. The intern who is engaged to the sexy neurosurgeon attending. They're gonna think it's all just because of money." Derek frowned.

"They won't ... this isn't about the money."

"I know. But do they? _NO_." Meredith said, her voice shaking. "No, they don't know that this is real. But everyone seems to think that I'm just a fling. At least, Izzie does." Derek shook his head in despair. Why didn't she get it?

"You have to stop with that, Mer. Don't let Stevens define who you are. You are a wonderful, beautiful, strong, caring woman who is out to make the world a better place. Who has won many battles and has had a long road behind her and I know there is still a lot to come, I know that. But whatever it is, we'll do this. We'll survive. And you will survive meeting my mom. But there is me and I will be there, every teeny tiny little step of the way." Derek's blue eyes were gazing at her intently.

Meredith sighed.

Her horror imagination had come true and that so suddenly with absolutely no warning at all. This was not fair. "Ok, how much ground do I have to make up?" Derek looked at her like he didn't what she wanted from him. "What are you saying, Mer?" Derek asked, frowning. Knowing himself that it wasn't fair to drop a bombshell like that on her and expect her to be okay afterwards. "How much do they hate me already?" Meredith asked, resignedly. Derek shook his head.

"We went over this already, Mer." Derek said patiently. "They don't hate you."

He doesn't possibly know that, does he?

"Why shouldn't they hate hate me? I'm the slutty intern who broke up your marriage." Meredith exclaimed hysterically, remembering the last time Nancy, the OB, visited Seattle. Originally, she had thought that that was his girlfriend and ran away. But it turned out that it was just his sister.

"So what?"

"They are gonna hate me instantly." Meredith tried to tell him, wanting to make him understand how she feels and why she feels that way.

"This is not going to be as bad as you think it will be." Derek reassured her, hoping he'd be right and not a complete liar.

"You think?"

Meredith searched in his eyes for confirmation.

Derek met her glance and told her silently that everything would be alright. "They will love you Mer. They just wanna meet you, my future wife. And I want you to meet them so you can have an actual family."

That was sweet. But would they accept her?

Maybe ...

Maybe not ...

Probably not ...

But maybe they'd surprise her ...

... and everything wouldn't be as bad as it seems right now.

"You are my family and Cristina - she is my person, Alex ... he's like my big brother ... and then there's you. _You_ are my family, Derek." Meredith replied softly, wanting him to understand what she was trying to tell him.

He knew how bitchy Nancy could be to someone who wasn't *fitting* in. She still considered Addison as her right sister in law even though Derek and Addison were divorced by now. "Come here." He stretched out his arms and Meredith immediately got the hint. He enveloped her with his arms. Soon, she was in Derek's arms and breathing in his scent. For a moment, she forgot about the McFamily visiting. For a moment, everything was normal, about as normal as it could possibly get. "I love this. More of this I say." She mumbled quietly. Derek grinned. He had known that this would calm her down. "I'll second that." Derek chuckled lightly and for a moment he forgot about the impending reunion with his family.

Where his family would be meeting the love of his life. Meredith Grey.

And it really has been successful.

"I love you, Mer. You know that right?" Derek said quietly. They didn't say them very often.

Meredith smiled even though she knew Derek wouldn't be able to see this. She did too. She snuggled into Derek and so they stayed for a moment. Then after some time, Meredith reluctantly looked up.

She asked: "Do I really have to meet them?"

Derek's blue eyes averted from her to the wall as he determinedly stared at it. He breathed in deeply before attempting to reply to Meredith's question.

"I'm not pressurizing you to do anything you don't want to do." Derek looked at her dreamily. With that gaze that said that he'd won a prize, that said that she was the best that's ever happened to him. Where he thinks that she's a present. That's _the _look he's giving her now. And she melted when she saw that. That's what she loved about Derek.

That he was giving her the choice to decide whether she is ready for this or not.

"I know. But I need to. I need to meet them. Otherwise they are gonna that I don't have the guts to face them, that I don't have what it takes. So let's prove them that our relationship is real and honest ..." Meredith suddenly said determinedly. Derek gaped at her since he was so surprised that she suddenly has changed her mind about meeting the Shepherd family. "Really?" Derek asked. "Well, I have face my fears, head on." Meredith replied, pecking his cheek before storming off to find Cristina for some freak-out time.

* * *

_**And the only way to get rid of a shadow is to turn off the lights, **_

_**to stop running from darkness and face what you fear, head on.**_

* * *

"Hey, Mer." Cristina called out, she just made a stop by the vending machine to get some food. And surprise, it was working. Which isn't always the case. Meredith shortly looked up before going back to staring into nowhere. "Mere, whatcha doing?" When Cristina noted that something was going on she tried to get Meredith's attention. "Mer, what is going on? Did something happen?" But when there was no response coming from Meredith, Cristina sighed and tried to think of ways to get her to talk. She bet it had something to do with Derek. "Mer. I've heard something in the news. _There will be a tsunami later this day, so we'll have to evacuate and go inland._" Cristina told her as she sat down on the gurney in the hallway where her friend was sitting as well. who seemed absent today. Saying that seemed crazy 'cause for one it wasn't real and second it's too big a thing to make fun off. But Meredith didn't seem to have heard a word from what Cristina just said. Cristina didn't think so.

She knew Meredith well. The young surgeon knew when her person was listening to someone and when she didn't. And right now she wasn't listening to her 'cause she seemed to have her own problems apparently. She nudged her arm gently. "Have you heard a word of what I just told you?"

Meredith turned her head toward Cristina and was now looking at her.

"What were you saying?" She finally asked back. "Oh, it responds." Cristina exclaimed while Meredith rolled her eyes at her friend. "You weren't listening." Cristina then said. "Uh, sorry there is just a lot going on right now." Meredith buried her hands in her face and wanted nothing more than to disappear, rather than going back and having to meet with the Shepherd family.

Nancy already hates her and the others will hate her too, instantly. She was sure about that.

Derek always says that she's making this up but Meredith doesn't feel like she's making this up. She just has no idea how this thing works. She didn't grew up in a big family. Her family is small. Really small. She doesn't have siblings with whom she grew up with. She had Lexie and they met once in the supermarket. They were supposed to meet but then Lexie had to postpone due a family emergency. Meredith had been very understanding.

She'd told Lexie to call her sometime. She wanted to get to know her sister before she got to know anyone else's sister.

Her life already was complicated enough ...

She hated complicated.

Why can't it be simple? Easy for her?

Just once.

That's all she wanted.

Her whole life consists of complications, complicated family constellations and so on.

"There's always a lot going on in your life, Mer. You're like a magnet for the bad things." Cristina only replied, semi-interested in Meredith's current problems. "Thanks, 'cause that makes me feel so much better." Meredith replied sarcastically. Cristina gazed at her friend. "So what, you know that I am right." She said, reading an article about _Secondary Arterial Switch Operation_. "Yeah, apparently as right as always." Meredith scoffed.

"I'm scrubbing in on a _VATS operation_." Cristina suddenly said, wanting to get her to think about something different than whatever's occupying her mind. "You're kidding right?"

That got Meredith's attention.

"Really, Burke allowed you to scrub on a video-assisted Thorascoscopic surgery?" Meredith's eyes lit up. "Wow, wish I'd be on that case as well. Maybe I could avoid meeting the family if I had been assigned to a surgery." Meredith thought loudly.

"Jealous?"

"No. Ok, yes but only because I have to go and meet McFamily."

"He makes you meet his family?" Cristina asked. "Ugg, I still remember the day when Burke's parents walked in ..."

"... on you and Preston, you half-naked. You were a dirty, dirty stripper." Meredith laughed when she thought back at that scene. Cristina glared at her annoyed.

"Mama Burke thinks I'm a racist, dirty stripper and that's Tyler's fault. He was supposed to guard the door."

"He had a code blue, Cristina." Meredith reasoned.

"And I had parents walk in."

Then Meredith noticed that Cristina was reading something. "Are you studying for your VATS procedure?" Meredith asked curiously. "No, I'm not. I'm reading ... articles." Cristina avoided. Meredith rolled her eyes and grabbed the issue Cristina was reading in. "Do I have to do everything myself?" She grumbled as her eyes catched the headline.

It was about Secondary Arterial Switch Operation in patients with a previous Mustard or Senning operation. "Cristina. Why are you reading this?" Meredith asked, a serious tone had taken over her voice.

"I ... wanted to look into options."

"What you can do if my right ventricle fails. But I'm not undergoing another procedure, not when I don't have to do so."

"Only if it's medically neccessary." Cristina said.

"But if it comes down to that, you're doing it. The procedure, I mean." Cristina asked, referring to the mentioned surgery. "Yeah, if my life depends on it, sure. But the last time I had some kind of surgical intervention I almost died due to a post-op complication. I don't wanna risk it coming to that again. You've seen how bad it was. You know almost killed me."

"Instead of saving your life, I know. Doesn't mean I can't look into other options."

Cristina shrugged.

"Whatever."

For a moment they both sat there in complete silence.

"I have to go, I told Derek, I would be right back."

"So he's making you meet his McFamily. Run, Mer, while you still have the chance." Meredith looked at her, unsure. "I was kidding." Cristina rolled her eyes. "Now go. Meet them and come over later 'cause I want details, all the juicy details ..."

"Yeah, I gotta go."

* * *

**Derek and Carolyn's conversation over the phone one month ago**

"_This is Dr. Derek Shepherd." He said his name, then he paused while frowning. Meredith looked at him in confusion. "Mum?" He asked surprised. Meredith's eyes went wide as she heard that and she was fighting the urge to flee. "Is that you?" He asked. Meredith looked at him with big eyes. Meredith couldn't hear what Derek's mother was replying. "I know. It's just been a whole lot, I had no time to call." Derek said. Pause. "I know you want to get to know Meredith, I am aware of that but it can't be right now. Meredith has a lot on her plate right now. But yeah, you'll meet her sometime after I talked to her about when and where and the whole thing." Derek stood up and left the room. _

_Now he finally had his privacy without Stevens looking at him._

_"I did propose." He said, spilling it. He knew his mother was dying to know how it went. _

_Considering Meredith hadn't run for the hills, it can't be that bad. "How did it go?" She asked over the phone. "It was … she said 'yes' to marrying me, Mum." He sounded happy, really happy for the first time in his life since everything ... "I am so happy for you, son." She retorted as she congratulated him._

_"I want to meet this woman who has saved my son from his lousy marriage."_

_"You knew I wasn't happy?" Derek asked, shocked, positively shocked. "Yeah, I know you, Derek and that your whole life. You weren't happy in your marriage to Addison. But clearly, this mysterious girl I have never even met has captured your heart and you're you again. So yeah, I want to meet this woman you made my son whole again. So, whatever you do, can we meet her at some point, maybe before the wedding?" Derek breathed in deeply. A single tear was running down his cheeks. His mother approved. This was it. "I'll talk to her about it. But I can't make any promises." Derek warned her._

_"She isn't too big with the whole family thing. There is a lot of baggage. A lot of baggage but you know, she is tough and smart and funny. She is the right one."_

_"That's why I want to meet her." Carolyn wasn't too shy to answer._

_"Okay, Mum, thanks for calling. I really have to go. I have a surgery in an hour. Another hospital requested me for a consult."_

_"Good, then I won't keep you from your work any longer." Meredith knew she had to meet the McFamily as Cristina would say, sometime. But she hadn't expected it to happen this soon. He took a big sip of his coffee._

_ "I just wish you could come with me to work." Meredith said longingly. "Oh, come on it's just a consult." Derek said. "I am aware of that, also I am planning to visit my mother." Meredith bit into her toast. "I haven't been there since before surgery so it's time." Derek nodded, softly nudging her shoulder. "I can come with you." "You have the consult with Mercy West. Why are they even asking for you? Don't they have any neurosurgeons?" Meredith wanted to know._

_"Yeah, they have but they aren't as good as me."_

* * *

"I take it that you're Meredith, the woman Derek's so crazy about." Carolyn stepped forward, a simple smile on her face and extended her hand. Derek tossed her a reassuring smile as Meredith looked at him for a second before turning her gaze back to Derek's mother who was looking at her. "Ye ... yes, that's me." Meredith stammered, her heart thumping loudly in her ears. "I'm Meredith." She confirmed. The girl who broke up your son's marriage. But she didn't say that part. It was enough that she was already thinking that Carolyn was thinking that. The girls were keeping their distance. Derek told them to do so. Meredith was grateful for that. This was all very overwhelming for her. She'd never done this before. Meredith shook Carolyn's outstretched hand awkwardly.

There's just so much that time cannot erase.

She had absolutely no idea how this works. How could she? She never had to meet someone's parents up until now. She never had a boyfriend long enough to experience that. She had no idea if she was being tested by Carolyn by telling her to address her with her first name. Meredith had absolutely no idea. "It's so nice to finally meet you."

She smiled warmly at her. Meredith's cheeks reddened instantly.

"I'm Carolyn Shepherd." The woman said. Please call me Carolyn, Meredith. I can call you that right?"

Meredith nodded, taken by surprise. She most certainly hasn't expected that kind of kindness toward her. She'd expected harshness, disdain or that she wouldn't be good enough, that she wouldn't fit in. But apparently, this wasn't the case.

* * *

**A/N: Thank you for reading.**

**VATS is short for video-assisted thoracoscopic surgery. ****It is the visual examination of the lung surfaces and pleural space through a viewing tube. Thoracoscopy can also be used for certain surgical procedures. When it is used for surgery, the procedure is often referred to as video-assisted thoracoscopic surgery (VATS). The most common means for obtaining a sample of lung tissue for a biopsy is with a thoracoscope. A thoracoscope also may be used in treating accumulations of fluid in the pleural space (pleural effusions) (Merck Manual).**

**Please review.**


	49. Chapter 49

**Chapter 49**

* * *

**"There's nothing else we can do for you." These are the last words a surgeon wants to tell a patient. Giving up doesn't come easy to us, so we do everything in our power not to. For surgeons "lost cause" just means "try a little harder". When do you throw in the towel, admit that the lost cause is sometimes just that? There comes a point when it becomes too much, when we get too tired to fight anymore. So we give up. That's when the real work begins, to find hope where there seems to be absolutely none at all.** Hope For The Hopeless, Meredith Grey

* * *

"I take it that you're Meredith, the woman Derek's so crazy about." Carolyn stepped forward, a simple smile on her face and extended her hand. Derek tossed her a reassuring smile as Meredith looked at him for a second before turning her gaze back to Derek's mother who was looking at her. "Ye ... yes, that's me." Meredith stammered, her heart thumping loudly in her ears. "I'm Meredith." She confirmed. The girl who broke up your son's marriage. But she didn't say that part. It was enough that she was already thinking that Carolyn was thinking that. The girls were keeping their distance. Derek told them to do so. Meredith was grateful for that. This was all very overwhelming for her. She'd never done this before. Meredith shook Carolyn's outstretched hand awkwardly.

There's just so much that time cannot erase.

She had absolutely no idea how this works. How could she? She never had to meet someone's parents up until now. She never had a boyfriend long enough to experience that. She had no idea if she was being tested by Carolyn by telling her to address her with her first name. Meredith had absolutely no idea. "It's so nice to finally meet you."

She smiled warmly at her. Meredith's cheeks reddened instantly.

"I'm Carolyn Shepherd." The woman said. Please call me Carolyn, Meredith. I can call you that right?"

Meredith nodded, taken by surprise. She most certainly hasn't expected that kind of kindness toward her. She'd expected harshness, disdain or that she wouldn't be good enough, that she wouldn't fit in. But apparently, this wasn't the case. After they exchanged pleasantries, Carolyn ended the conversation when she said: "Derek, do you have an idea where I can find Mark Sloan?" Derek grinned.

"I think he's in surgery but he'll done soon since it's just a liposuction." He told his mother.

"Aha."

Then a pause followed. Meredith stood there awkwardly, hoping that someone would say something. Derek's sisters weren't here. They were staying somewhere else in this hospital, most likely visiting Addison or something or getting coffee. Derek had no idea what his sisters were up to.

He just hoped that they would give Meredith an actual shot.

So, Carolyn walked off to find Mark, giving Meredith the much needed opportunity to calm down. When she found Mark near a coffee cart, flirting with some nurse she exclaimed loudly, causing everyone to turn around and look at her. "Mark Sloan!"

"Mrs. Shepherd." He said. "Mark, you know how to call me." She said. This was her way of saying _cut the crap_. Mark had they face as he had when he put Derek's favourite frog in the microwave but didn't press start. "You were ..." Carolyn started to ask him. "I was hitting on that nurse ..." He gave in. Carolyn frowned. Mark hadn't changed a bit. "I'm ... sorry for doing it. It was wrong." he was now referring to the incident with him and Addison. "It was, Mark. I am disappointed. But everybody does mistakes. So come here." She hugged him.

Mark was surprised. "Why aren't you hating me for breaking up Derek and Addison's marriage?" He asked.

"He wasn't happy and because of you, because of what you did, he's found true love. I spent moments with Meredith but I think I do like her. She's ... I don't know ... different. But a good different. So I think what you did actually helped him. You're still family, Mark, no matter what." Carolyn assured her.

Mark hugged her for another time as reply. He really loved his brother's family.

They were his family.

That family that actually cared about him ...

Derek led Mer toward an on-call room for some privacy. In that moment, Bailey crossed their way. She eyed Meredith for a second before turning her eyes at Derek and glancing at him with a not so nice face expression. "What's wrong with her? Or more, what did you do to my intern?"

"She's not an intern anymore." Derek replied, not daring to look at her.

"For me, they will always be my interns, my babies. So what did you fool do? She's always doing okay until you come along and do something that makes her look like she's ready to jump off a bridge. So what did you do?"

Bailey was staring him down like only Bailey could. She was incredibly good at those things.

"My family showed up."

"Here?"

"In Seattle?" Bailey asked, frowning as she glanced at her intern who still hasn't said a word.

But she knew Meredith was not happy about the whole situation. She could see it on her intern's face. "I take it you didn't know?" She then directed her question to Meredith. "No I didn't. That's why I'm so overwhelmed. This came out of nowhere. I never expected it to be now …" Meredith said, looking at her superior.

Bailey eyed Derek for a slight second before saying: "You better make sure I get my intern back in a halfway normal condition, meaning not crying or looking like that afterwards. If I do get my intern back that way, you won't be working with her for the next month. We clear?" Derek could only nod.

Meredith was surprised at Bailey's attitude too. She hadn't expected that they cared so much.

"I didn't know either." Derek tried to say. Bailey only huffed as if she was to say 'And I am supposed to believe that, McDreamy.' Meredith tried to hold back a laugher. Bailey's appearance had lightened her mood and she had no idea why.

* * *

"Addison, I heard about this case you have." Nancy asked, ok, not really asked, more pressed for information. "You mean the woman with the two uteruses?" Addison asked, glad that she was able to change the topic. She really did not want to talk about Meredith Grey. "Two uteruses …? Did you really just say that?" Nancy was elated, now at the mention of a possible interesting case. "Yeah, I did just say that." "Woah, I hope I can get hospital privileges and scrub in if there are any complications. I haven't seen something like this before in my whole career." Nancy said, her and Addison always had something to talk about, since they shared the same specialty. Obstetrics and Gynecology. "I can imagine 'cause I haven't either." Both women laughed loudly, causing some nurses and visitors to turn around and look at them. When they finally stopped, Addison asked her: "Do we wanna go the cafeteria, eat some hospital food and get a cup at coffee?" Nancy looked at her before agreeing to the 'coffee' part but declining the 'food' part.

"Coffee sounds good." Nancy agreed. "But the food? Gee, thanks, I am not really a fan of hospital food."

She chuckled.

"Thank god I don't have to eat it." She said lightly afterwards. Addison glanced at her, knowing that this was just casual conversation and that Nancy was waiting for her to let something slip about Meredith Grey. As much as Addison Nancy liked (as a friend) she didn't want to do that. She'd always been loyal.

"Since you don't work in a hospital." Addison added what caused Nancy Shepherd to look at her in a weird way.

Nancy rolled her eyes. "Yeah, I have my own practice."

"I know." Addison replied.

"Well me neither. Remember this restaurant in NYC where we always went to when you came to visit us? The Italian restaurant." Addison said, they continued to make conversation about where is the best place where you can get food. "Oh, I do remember. The decorations and the food - the food is the best. That's definitely undeniable." They walked along the hallways, finally reaching the cafeteria. Almost all tables were occupied.

"Now that was a brilliant idea." Nancy said bitchily as she eyed the room suspiciously.

Addison thought that it was best not to answer if Nancy was in that mood.

She instantly noticed her moodiness.

"Let's just go get coffee." She said, dismissive. "We'll find a place to sit down. Believe me, in a few minutes, the cafeteria will clear up and there will be a lot of tables for us to choose from. There's no need for you to panic." Addison muttered.

Nancy stopped.

"Is something wrong?" She asked tentatively. "Just don't ask me about ..."

"The slutty intern?"

Addison got cut off again.

"What can you tell me about this Meredith girl?" She asked, her eyes fixated at the red-haired doctor standing in front of her. Addison had no idea what to reply. She knew how judgmental Nancy could be and she also knows what Meredith Grey has been through the last few months, recovering from open heart surgery. "Uh, it might be better for you if you talk to her yourself. It is not really something I can tell you." Addison avoided her question. That Meredith was born with a CHD was now general knowledge in the hospital but still, not everyone needs to know about. "So she's hiding something, maybe …"

"But maybe it's just none of your concern." Addison simply got out.

"What the hell? _Addison_! You are defending her." Nancy called out in shock. "You're defending the girl that has wrecked your marriage. What the hell?" She continued. Addison rolled her eyes.

"You are overreacting." Addison glanced at Derek's sister disapprovingly. "I _am _overreacting? I will show you overreacting."

"Meredith is actually very nice once you get to know her. Just give her a chance. Everybody deserves a chance and deep down you know it." Addison retorted calmly. Nancy's eyes sparkled as she looked at the baby surgeon. She huffed as if she had no idea what just happened. What just happened was that Addison, Addison of all people, told her to back off.

She could not really imagine this.

* * *

Meanwhile, Meredith had other problems. She was going to meet the Shepherd clan in a few minutes and she was worried crazy about how it would turn out. She was positive that it would be a total disaster, especially with her track record. She wasn't Addison with her super long legs and her being a famous surgeon. Sure her mother was Ellis Grey who invented the *Grey Method* but she ... was an intern ... had split ends ... they'd think she was some gold-digger who wanted his money. "Are you sure this is a good idea?" Meredith asked Derek as they both entered the restaurant where they were supposed to meet Carolyn and Derek's sisters. He'd made a reservation for the seven of them. Derek already saw his mother and sisters sitting at the table he reserved for them. They were both off today.

"Mer … if you have second thoughts you can back out you know, I can tell them you got paged." Derek suggested. But Meredith shook her head and said determinedly: "No, I … have to do this." Derek's blue eyes were looking at her intensively. "Ok, then let's go." Meredith took a deep breath and ignored the shaky 'thump, thump' coming from behind her sternum.

So she took a leap of faith.

Taking a leap of faith was the important part and now she was ready (ok, lie! She wasn't ready, at least not as ready as she wanted to be but ok) for meeting them.

She was nervous, very nervous. She didn't think that she had ever felt this kind of nervousness before.

Not even when she had her annual cardiac check-ups as a child (She had those regularly, at least once or twice a year and sometimes even a cardiac catherization for making sure that her heart was working as expected and that her aorta wasn't stenotic 'cause that would have meant intervention). Meredith had been nervous, but this was a different kind of feeling.

The young surgeon had absolutely no idea what to expect, Meredith has never done something before. Derek knew that. She was breathing more shallowly than normal, indicating that she was nervous about meeting his family. He looked eyes with her wanting to tell her that everything was gonna be alright.

"But you don't know that." Meredith muttered under her breath-

Derek's eyebrows arched as he glanced at her. He pressed her hand reassuringly.

Derek grasped her hand with his. She felt the warmth coming from him and for a moment, a small moment, she relaxed. But that feeling disappeared as soon as she got view of the people sitting there, waiting for her and Derek to turn up. Then Meredith stopped abruptly: "Derek."

"What is it?" He asked, strained.

"Don't mention … you know what. Just don't mention it. It's enough that they think I'm a slutty, home-wrecking intern." She didn't add 'They don't need to know about my crappy heart.' Derek knew what she meant without that sentence. He knew that well.

Her voice shook a bit at the end of the sentence.

"My home was wrecked before I left Manhattan, before I found Addison in bed with Mark, Mer. You are not a homewrecker." He assured her while keeping his voice low. The people at the other tables were chatting happily and they were laughing and having fun. No awkward conversations Meredith was about to have with her fiancé's family. There were candles lit. It was romantic, Meredith instantly noticed that. The atmosphere was good. Or it could be romantic if there wasn't the dinner with the McFamily.

"And don't worry, I will try not to mention it and if it comes to that, I can try to steer the conversation in a different direction." Derek finished.

Meredith pressed his hands as an answer. Derek's assurance was enough for her at the moment.

"Derek, we are over here …" His mother called out, waving at them. Meredith politely greeted Carolyn in a more formal way but Derek's mother reacted differently than Meredith would have anticipated. She pulled her into a hug. Meredith was astonished at Carolyn's reaction. Derek smiled happily. He loved his mother for making such a nice and loving gesture to Meredith whom she didn't really know. But that was his mother. Loving, caring, and she was the opposite of judge-y.

"It's nice to finally meet the woman who has captured my son's heart."

Meredith could see Nancy's expression. Her face expression was telling her that she wanted to vomit. Even Derek looked slightly embarrassed but Meredith figured it was because of how the sentence was formed.

„So, Meredith, let me get this straight. You are an intern, he's an attending. Doesn't seem that strange to you? I mean why him? Why her … Derek, look, she is with you because of what, money?" Nancy said in a biting voice. "I'm a resident. I'm starting my second year now." Meredith answered, she felt Derek looking at her worriedly. She almost snapped her 'I'm fine' at him but considering her current situation that might not be the best idea. "But you were an intern when you met him. He's a catch, he truly is but I don't understand why he chose you. Addison …" Meredith's stomach churned and she swallowed down acid. She'd been right in assuming they'd hate her. And apparently, they do hate her. It was clear which side Nancy has chosen.

Didn't she know Addison cheated on her brother?

Or is she ignoring the truth so that it fits her agenda?

Derek was fuming.

He couldn't believe that Nancy dared to say something like that like there was nothing wrong about it except there was everything wrong about it.

"Nancy, stop it." Derek warned her with a low and angry voice, he felt the increased heart rate when he was looking at Meredith's face. It told him everything he needed to know and it pained him that his family was the source of this.

"Derek, I'm your sister …" Nancy bluntly replied while throwing a glare at Meredith.

"Yeah, I know that. But that does not mean that it gives you any rights to barge in here and say that ..." "The slutty intern ..." Nancy interrupted coldly.

Meredith's face paled and her heart was beating hollowly in her chest. She felt like she was sinking. This was what she dreaded. Now it was happening. Why wasn't Derek saying anything? Did he believe the crap Nancy was saying right now? Meredith felt helplessness creeping up in her, making her feel insecure and helpless - like she couldn't do anything to defend herself. That was weak. There, again she was weak because she could not stand up to Nancy and her bitchiness.

Derek said nothing for a moment before it was too much.

He saw Meredith's face that was telling him everything he needed to know. He saw questions.

Derek saw that she was scared he'd leave her.

But he wouldn't do that, not ever.

"_Meredith_, Nancy. She has a _freaking name_. Call her Meredith, damn it." He gritted out, fuming.

"Call her by her name or don't talk to her at all if you can't be civil." Nancy looked like she'd bitten into sour lemon. "I can leave." Meredith offered, her heart was beating hollowly in her chest. She was not fitting in. How could she have thought that maybe she would be fitting in if there was no actual way to be fitting in? "I have tons of work to do at the hospital ..."

"That would be great." Nancy's eyes lit up when she said that.

"NO, Meredith. Stop. Nancy, what the f**k are you doing?" He got up and slammed his palm on the table. "So I met her in a bar, so what? What is your problem, Nancy? Tell me why you treat her like that. Why you treat the love of my life like that?" Derek snarled angrily. Meredith looked down, unable to face anyone sitting on the table. She never thought someone would love her, the way Derek does. "Derek …" Carolyn said. "No!" He said with vehemence. "You listen to me, ok?"

He panted.

"She …"

Meredith felt her heart flutter. Derek was doing this for her.

"I picked her up. I … I was the one to pick her up at the bar across the street from the hospital. She was trying to ignore me. But I was persistent. She was drinking tequila and had this beautiful black dress on. When I asked her out I felt like that was the woman I want to spend the rest of my life with. I know it is gonna sound like cliché but it's not. I had no idea she was going to be my intern."

Derek released a sigh, looking at each of his sisters before continuing: "She was just a girl in a bar and I was just some random guy. But love – love always finds a way to bring two people that are destined to be together, together. That's what I think."

Nancy shut her mouth.

"I had no idea that I would be her boss. She had no idea who I was, she didn't know about Addison either. You cannot blame her for breaking up my damned marriage. It was broken before the thing with Mark ever happened-"

"So why can you forgive Mark but not Addison? Why not try with her again?" Nancy just couldn't let it go.

"I don't love her anymore." Derek exclaimed loudly.

That exclamation made several people from other tables turn around and face Derek who was rushing his hand through his hair in a distressed manner. Carolyn noticed that and put her hand on top of Derek's in a calming way. She looked at him, telling him to calm down.

"What do you mean, you don't love her anymore? She is great, a great woman and a great woman." Nancy tried to tell him. "Yeah, I know you are best friends and all but you have to know that sometimes love just doesn't make any sense. And I love Meredith in a very big way, letting her have the last piece of cheesecake, so I'm picking her, I choose her and not Addison because I love her … she is the one for me." Derek's blue eyes were at her, he smiled dreamily.

At her.

Meredith breathed in deeply, a small smile broke over her face.

"How am we supposed to know that?" Carolyn interjected softly, collected. Meredith looked up scared of what was to come. "You just left New York and everything else behind. Your practice, us … you never called. I had to call you." Carolyn reasoned. "I know and I'm sorry for that but there has been a lot going on and I had no time …" He shot a view at Nancy, "… to deal with my extremely nosy family.

"You had no time to call us?" Kathleen said. "You left without a note."

"How am we supposed that this isn't some cheap midlife crisis?" She then asked, avoiding looking at Meredith. Meredith coughed as wanting to say, hey I'm here as well, please notice me.

"You're being unfair to him." Amelia cut in. Her voice was steady and collected.

"Give him a chance to explain for god's sake."

Derek looked at his youngest sister gratefully. She glanced at him for moment before focusing back on her food. Her eating skills were similar to Meredith's. They both have had their fair share of problems in the past … Thanks, he told her silently. Amelia caught this and nodded imperceptibly.

Nancy noticed that and only scoffed. This was getting better and better.

"She saved me. She saved me. I was drowning in my sorrows and she saved me. Without her I'd still be sucking down water ... She saved me and you're treating her like she consciously decided that it would be nice to wreck my marriage. My marriage was over before I met her. But I didn't know it until I met her. She's smart and she is funny. She diagnosed a patient with an aneurysm before I did. She figured it out. She's a great doctor. Just give her a chance ..."

Derek finished. Everyone was staring at him. Meredith couldn't take anymore. She hoped somebody would say something to make this less awkward.

But then Lizzie changed the topic, thankfully.

"So what are you doing?" Meredith asked, addressing Lizzie. Lizzie looked up, chewing. So it took a few seconds before she was able to answer. "I'm a pediatrician. I work with kids, and have my own practice back in Connecticut." She answered. "You're a pediatrician?" Meredith asked, her voice only changed tone slightly. Only Derek noticed the almost inaudible change in her voice. "I am." Lizzie Shepherd confirmed. Meredith's thoughts were all over the place.

Had Derek talked to her about her since she was a pediatrician?

About her and her CCHD?

Meredith took a deep breath before she was able to continue having that conversation with Derek's older sister. Nancy was the oldest, then Kathleen and then Lizzie, followed by Derek and Amelia who was the youngest. "So I hear you're an intern." "Well, in fact, I'm a resident." Meredith corrected absentmindedly. Kathleen, Derek's mother and Derek were just listening to them talking. But it wasn't an uncomfortable silence.

"Right, you're entering second year, aren't you?" Lizzie asked for confirmation. Meredith had the feeling that all Shepherds' had the tendency to being very chatty. Meredith nodded.

"I am." Meredith confirmed.

That's when Nancy cut in again. "Do you know what Addie told me?" Nancy stared at Meredith for a few seconds. A cold shudder shot through her as she saw how Nancy looked at her. Suddenly, her breathing quickened due to the current situation that wasn't very relaxing at all. Kathleen diverted her attention to her older sister.

She knew Nancy's habits. Knew that she was going to bitch again, now any seconds from now ...

"Nancy, if you're going to start bitching again, cut it out. We've been over this already." She tried to nip the upcoming snarly remark from Nancy in the bud but there wasn't very much she could do.

"Listen to the psychologist." Nancy muttered in a sarcastic snappy tone. Derek sighed, he loved his family but in moments like this he was just annoyed by their indescribably unbelievable behavior. Sometimes he just did not get his family. He saw that Amelia wasn't engaging in Nancy's provocation. He was grateful for that. He dared to look at Meredith.

She sat there, tense. Her face turned away from him so he couldn't see her face expression.

"She …"

She gazed at Meredith for only a second and Meredith could read scorn and disdain. She once again felt out of place. "She is thinking about leaving Seattle." And that was just the precursor, Meredith knew that there was coming something else as well. And with that, Meredith couldn't take the dizzying feeling anymore. Tears blurred her eyes but she wasn't about to let them see what Nancy's harsh and demeaning comments did to her. She'd experienced that when she was in school. She doesn't need to experience it again here. She shoved her chair away from the table. Meredith had enough of Nancy trying to pick her apart. This wasn't a friendly and genuine getting to know you conversation, instead that was an interrogation.

She was being interrogated by Nancy who seemed to think that it was okay to treat her like this.

"I …" Meredith stuttered as she was standing there, her hands still on the table. Then she let out a flustered sigh and stumbled over words as she tried to say something. "I … can't, do this … I have to … go." Meredith felt her cheeks redden and that only made her more embarrassed than she already was. With that, she turned around, ashamed of herself. She was fleeing, fleeing, fleeing, she needed to get away from those people. They don't leave her any room to breathe. Outside the restaurant she stopped. It had started raining again. But that was Seattle. She let the cool fluids run over her face. For a moment she was just standing, there panting. She closed her eyes. The surgeon had no idea how much time has passed.

It was easy to lose track of time.

Suddenly, someone was talking to her. "Are you okay?" Someone had noticed she was standing on the pavement, trying to calm herself down. "I'm fine." Meredith only replied. "I just need a moment to regain my senses."

The man nodded, before asking: "You sure you okay?"

"I'm a surgeon. I know when I'm not okay." She just hoped that everyone would be leaving her alone, just for a few seconds. She wasn't going to pass out. She knew the signs and symptoms. Right now it was just the situation that was enough for her and that made her needing a break from all the family.

* * *

As Derek watched Meredith escaping his family, he was angry at Nancy. Those things were none of her business. "Nancy, don't you dare going on with that sentence. I'm ashamed that you behave like that. Meredith has had enough experience with that kind of behavior and she doesn't need you to treat her like this. She's smart and funny and the love of my life. If you can't accept that … I'm … I have to see how Mere is." Derek said with a worried undertone. Only his mother noticed that. With that he got up and started looking for Meredith. The neurosurgeon hoped that she hasn't fled the state. But when he exited the restaurant he noticed that it was drizzling. Then he saw her standing there, eyes closed. "Meredith." He called her name. She didn't turn around right away. He fastened his pace. Why wasn't she wearing a jacket or something, he cursed inwardly. She could catch something, like maybe just a cold but it is Meredith he's talking about.

"Meredith." He called her name again.

That's when Meredith turned around, her face was dripping wet and her arms were clutching her torso tightly in an attempt to keep herself warm. It was cold and windy outside and Meredith was shivering even if only slightly. She reacted very sensible to changes in outside temperatures. So she was trying to keep herself warm. But no matter how hard she tried to it was still cold and freezing. So much for trying to keep herself warm … But apparently, she wasn't very successful at it. Somehow the second year resident wished that Derek was here, enveloping her with his warm body. They'd be at home, enjoying a movie together or just watching some television series.

Anything was better than having to deal with Derek's family.

Anything was better than that.

Meredith would gladly take up night and day shifts to avoid them. But she couldn't avoid. They were right her in Seattle.

"Mer, what are you doing?" He murmured softly. "Had to escape them – especially Nancy … I'm sorry for making you look like an idiot." She whispered back.

"Do you want to go inside to get a little warmed up? You're freezing, Mer." People were walking past them without noticing them. For them, they just seemed like a normal couple that's talking about something.

"If you were to play the 'you're post-op a heart procedure'-card, I would have to kill you." Meredith said, breathing in, not even noticing that she was indeed shivering.

"I was never planning to say that but maybe it'd be a good idea for you to come back inside with me."

"Derek." Meredith said, looking away.

"They hate me. This is a mistake ... I never should have come." Meredith stuttered, suddenly feeling exhaustion taking over.

"Families hate me. Fathers leave ... and mothers and siblings, I have no idea but what I do know is that families don't like me. They don't like me. Compared to Addison, I'm plain I am nothing. You are a neurosurgeon, and have things accomplished ... I just started my career. They will hate me. Plus I have a really crappy heart and ... a failing heart isn't very sexy." She laughed joylessly. Meredith seemed distressed, and on the verge of freaking out. Derek despised what his family did to the love of his life, making her feel like worthless shit. "They won't love me, they already decided not to like me. I don't fit in. I'm just ... me. Meredith, unworthy of being loved. That's me." Her breathing began to change, she was freaking out and losing her breath.

Oh no, Derek thought, that wasn't good.

"Sh, Meredith. Breathe. Just breathe."

Meredith panted, trying to suck in air but didn't really succeed. She was having a panic attack.

His family made her have a panic attack.

He was rubbing her back in circles as he was trying to soothe her, to calm her down before this ends badly. He was worried. Mer's breathing was still labored and she sounded she had to strain herself to be able to breathe properly. After a while, Derek was starting to get worried, Meredith slowly calmed down.

"God you really had me worried there." Derek observed Meredith closely, looking for any signs that might indicate that something was wrong with her.

"They do hate me and they think all this stuff or will be thinking all this stuff." Meredith said her voice hoarse. Derek didn't know what to do except reassure her. "They will like you, Mer. They will. They don't think any of this stuff. This is all Nancy. She's the only one who really liked Addison. My mom, she's ... great, she'll love you, she already does 'cause she sees how happy you make me. If my dad could've seen me today ..."

Derek looked away for a moment. His blue eyes were a bit watery.

Only Mer noticed that.

"I wish he was here to meet you. He always wanted me to find a wonderful woman to fall in love with and I have found this love the moment we locked eyes at Joe's Bar. Since then I knew that I wanted to wake up next to you ... every day ... conquer everything with you ... I love you, Meredith Grey. They will see that. We will make them see that _we're_ real. When they see how happy you make me, my sisters will love you. Perhaps your family and other families don't love you, but my family will and one day they'll be yours - this day will be here sooner than you think. They will see why my life is more colorful and worth living with you in it." He told her and pulled her as close as he could and placed a kiss on her lips. Meredith relaxed in warm hug.

She really loved this man, she does ...

"Life without you is meaningless and grey ..." He added.

"And you are anything but original, or plain. You are gorgeous, breathtaking, stunning, beautiful inside and out and I love you. I love you more than I ever loved Addison. I love you in a way I have never loved Addison. When I look at you I feel happy. You make me happy. I love your hair, I don't care if it has split ends. Your age doesn't matter. Love is blind to age. What does matter is I love you, Mer, more than anything in the whole wide world, and my family is going to love you because you make me so happy, happier than I was with Addison." He stopped. Meredith looked at him for a moment.

Derek continued, his hand was still rubbing circles on Mer's back. She was completely quiet.

And had calmed down.

She was now breathing beautifully. He was incredibly grateful for that.

"I was not happy not the way I am now and that's because of you because you saved me from drowning. I was drowning and you saved me. You are not slutty. You're sexy for me and only me. I don't care about scars. Yours are beautiful because they saved your life. You're perfect for me. You are it for me. I love you just the way you are, failing heart or not, I will be by your side."

Meredith cried silently, reacting emotional to what he said. His words touched her.

Deeply. Now she knew what Derek felt for her.

"Come on." He took her hand and he was walking back inside. Meredith had no choice but to follow him. "What are you doing?" She protested half-heartedly. Derek rolled his eyes. "I'm doing something I should have done way earlier which is making sure that they know what we mean to each other. That's what I'm doing. Nothing will stop me from doing that. You are important to me and I won't let them walk all over you just because they seem to think they can." Derek ranted.

"Well, they can I can take it." Meredith said, numbly. Derek knew she was lying and that this was doing her more harm than good. Meeting his sisters takes its toll on her, making her feel uncomfortable - at least Nancy does.

"I know but it's not healthy." Derek said, being reasonable.

"You wanna know what's not healthy either?" Meredith said sarcastic. "Having a heart that's failing to pump blood effiently to the organs ..." She was referring to the organs in the abdominal cavity, the brain - really important - when the brain doesn't work, then the rest doesn't matter anymore - and back to the lungs."

"Dark."

Derek had to laugh, unwillingly.

Meredith scrunched her nose as she saw how Derek reacted. "Well, you've known from the beginning that I am a dark and twisty girl." She said, also starting to giggle. After a while they both calmed down. "You ready to go back in there?" He asked, his hand was holding tightly onto Meredith's. Meredith nodded only, then she said: "I am. I mean, it can be worse than the first time. This is as worse as it can get. But I'll deal with it, I'll find a way to do so."

"Then good." Derek said.

* * *

**A/N: Hope you liked this. Please review. Reviews always make me happy.**

**Don't forget out to check out the prequel to this story: If Tomorrow Never Comes. It's mostly about Meredith and her challenging childhood. She survived when all odds were against her. Meredith's life mostly consisted of open heart surgeries, cardiac catherization and doctor's appointments but she also experienced love and happiness and real friendship throughout the years. She never let her medical condition stop her from having the life she wants ... **

**It's only one chapter long at this point but I will update at some point when there is some time left that I don't need to spend studying - especially with that History project. Have I mentioned that this annoys me big time? Because it does. I hope you liked it ...**

**Please leave a review on your way out ...**


	50. Chapter 50

**Chapter 50**

* * *

**You might be surprised, but anatomy classes can be uncomfortable for surgeons. We're trained to put bodies back together. We prefer our tissue warm, alive. Usually when a surgeon is staring at dead tissue, it means that something is very, very wrong. There are some things in life that simply can't be avoided, no matter how uncomfortable they make us and there can't be rewards in stepping outside your comfort zone. Even when the thought of it makes us want to puke. Even when we want nothing more than to run screaming for the hills. That's why people love to say that what doesn't kill you makes you stronger. But sometimes, those people don't know what the hell they're talking about.** Meredith Grey; Old Time Rock And Roll

* * *

After Derek left to go outside, there was silence at the table before Amelia started to talk. "You're treating her exactly the way you treat me. You know that right?" Amelia looked at her older sister. "I'm just little screwed up Amelia. And now you are doing this to Meredith, Nancy. Why? I'm just asking why? I know you love Addie but god, she _cheated_ on him. Why won't you get it?" Amelia supported Derek (although he wasn't here right now, but she felt she had to do it even though it was not an obligation). Her older sister just shook her head while laughing. Kathleen and Lizzie as well Carolyn watched them bickering but ready to cut in if the discussion gets too heated. "Why are you taking Derek's place? He's ... he doesn't like you anyways so why bother." Amelia swallowed dryly, not letting on how much Nancy's words had hurt her. She knew Derek was angry at her for what she did but does he really hate her? "Nancy, that's enough. Let your sister be." "I'm sorry, mother but I'm just stating the facts." Amelia scoffed. What the hell did her sister think? "What facts? You don't anything about her, Nance. How about you wait with judging until you know more about her? You don't know her background story. You don't know what her story is."

"Who cares what her story is." Nancy muttered under her breath. Amelia's eyes got wide.

"Shut up, Nancy. Shut up about it. I know Derek doesn't like talk to me but I love him anyways. He's my only brother. And Meredith? I don't know her. But I think she makes him happy and if that's case, it's great. You don't know her story. I don't either but the thing is - the difference between you and me - I don't judge. Not like you do. Because I know how much that hurts, getting stabbed in the back from people that are supposed to be your family and love you unconditionally."

Nancy huffed in response to Amelia.

"Amelia, we know." Carolyn interrupted her youngest daughter, painfully aware that she was treat.

Then she turned to her older daughter. "Nancy. What in god's name were you thinking?" Carolyn Shepherd exclaimed as she looked at her oldest daughter. Nancy bowed her head, knowing there was nothing she could say to make this better. She knew her mother very good and this was one of the moments where she can get really really angry - in a scary kind of way. "I am deeply disappointed, Nancy. I raised you better than this. You will apologize to this woman, okay? I don't know what's gotten into you but don't let it interfere with us wanting to get to know Derek's ... Meredith." Nancy looked at her mother. What was she hinting on? There was something, indeed.

But there was no way for her to ask that. She knew that.

It would be a lot better if she just kept her mouth shut for the time being.

Meredith and Derek re-entered the restaurant, his mother and his sisters were waiting for them to come back. Nancy was looking down on the table as her brother and his fiancé were back again. Apparently, Mama Shepherd had talked to her while they have been outside. Derek sent his mother a grateful glance. She simply smiled.

"What about your family?" Carolyn asked nicely as she stirred her tea. Meredith had no idea what to reply.

Derek had the perfect family and what did she have?

A father who abandoned her to ride off into the sunset with his other wife and family (although Lexie was actually a nice girl and Mer didn't want to admit it but she was), a mother who worked long hours, crappy childhood experiences with school, long and intermittent hospital stays due to her medical condition ... In short, her childhood kinda sucked.

"I ... uh ..." Meredith stammered slightly, her cheeks reddening instantly.

"I just want to get to know you, Meredith." Carolyn said as she saw Meredith's reaction to her question.

Meredith inhaled, feeling their eyes lingering on her.

"I ... I was raised by my mother. My father wasn't really in the picture. He left before I was born. It was just mom and me." Meredith finally answered. "My family isn't like ... I didn't grow up the way Derek did. I grew up as the daughter of a surgeon. That wasn't always easy."

Meredith didn't really know what to answer.

"Your mother is a surgeon?" Kathleen asked. "She was." Meredith replied, her fingers drawing circles on the table. "I'm sorry." She sincerely apologized. Everyone of them was now looking at her. Derek frowned, he looked over to Meredith who seemed a bit uncomfortable with questions about her family. That was to expect when knowing the history.

"She's not dead. She just doesn't operate anymore." Because she can't anymore. Meredith wanted to avoid the questions about her Alzheimer-y mother.

"Why?"

"I promised I wouldn't tell anyone. Some people know but I'm not really comfortable talking about it here."

Meredith's voice quivered a bit.

"Of course, we all have things we like to keep a secret." Carolyn answered while looking at her openly. Oh, if you knew, Meredith thought. That wasn't the only secret. She had a lot of secrets, some more explosive than others.

"Have you met your father?" Nancy inquired, eyeing her.

Obviously sensing that Meredith wasn't comfortable with talking about that topic.

"Yes, I have."

She wasn't disclosing any details.

"Does he have ... do you have siblings?" She then wanted to know.

"I have to half-sisters. Lexie and Molly." Meredith answered reluctantly. "Lexie's starting her internship as surgical intern at Mass Gen, Molly has a daughter. I only started to get to know Lexie. I don't have contact with my other half-sister. You see, I am not good with this whole sibling thing. I'm just learning. I didn't grow the way you did. I ... oh, god, I'm making a terrible impression of myself, don't I?"

Meredith laughed nervously.

Amelia looked at her, sensing there was more to what she just told them. "Meredith, it's okay. You don't have to answer every question they ask. They like to pry into other people's lives."

"Derek ..." Meredith said. "It's okay."

Derek leaned over to his mother, appreciating the fact that she was sitting next to him. He threw a quick glance at Mer before saying quietly: "She doesn't like talking about family." Carolyn put on a small smile and patted his hand reassuringly, with that telling him that she understood.

"Aren't the new interns coming this week?" Kathleen suddenly said, feeling Meredith's discomfort with the family topic. She'd started analyzing her, unwillingly. One of the curses of being a psychologist ... "They are." Derek confirmed. This was neutral territorium. So that was good. Meredith could do that, keeping the conversation on that level. "Do you know their names?" Meredith asked interested. She knew her sister was starting internship soon but at Massachusetts General Hospital in Boston. Derek glanced at Mer for a moment. Then he shook his head.

"How am I supposed to know that, huh?"

Derek gazed at Meredith.

Meredith shrugged almost imperceptibly. "Don't know. You always find a way which isn't that surprising. That's just who you are."

Then both Derek and Meredith's pager chimed loudly, interrupting the discussion that was heating up. Simultaneously both Mer and Derek glanced at their pager and then glanced at each other, understanding the other without having to exchange words. They knew what the other one was saying just by looking what the other one was thinking. "We're being paged." Derek got up from his as did Meredith.

"We have to go." Derek said, concern was in his voice as he read the message again. Meredith watched him closely. "Sure, go for it. But do the both of you have to go?" Amelia asked as she got up from the chair. "Yeah, we both have to go. Meredith is on my service this week." He said a bit harshly.

Amelia flinched a bit. She hadn't expected such a harsh reaction from Derek.

Amelia followed them outside. "Derek." She called after him. "Wait a second." Derek turned around, a partly annoyed look at his face. Amelia was walking towards them. "Derek, she's your sister. Be nice." Meredith warned him quietly. She did not know the history between those two but it was obvious that something has happened between those two. "I will come with you to the hospital. I want to talk to some ... people." Derek scoffed. He could only think of two people Amy would wanna talk to: Addison and Mark. Those two were the ones she knew at Seattle Grace. "Get in the car if you wanna go with us." He said coolly. Amelia sighed. Would he ever forgive her? We all do mistakes at some point.

Amelia glanced over to Meredith who seemed quite confused at the quarrel between Derek and Amelia.

But she did what she was told. Meredith stayed outside and shook her head in disapproval. "Derek ..." She said his name. Derek figured she wanted to talk what happened with Amelia but he did not want to talk about it.

He didn't like talking about it.

"Just leave it, okay?" He said with a rough voice.

Meredith stopped pressing for further information but decided for herself that she would ask him later.

Not because she wanted to annoy him but because she cared about him. And no matter how difficult the situation between him and his youngest sister was there has to be a way to stop this ... even though she had no idea how she'd do it. But that was a problem for later on.

Amelia, Derek and Meredith were standing in front of the OR rotation. Amelia asked her brother if she could scrub in on that case. But she knew she was more likely to receive a could no as an answer. But she was used to it. One glance into Meredith's face told her that she didn't understand what was going on her. Apparently, Derek hadn't really told her what happened years ago. She made a mistake, a giant mistake, and still, she was paying for it.

"Can I scrub in? Webber gave me privileges." Amelia asked as she saw Derek and Meredith standing in front of the OR rotation. She knew Derek would most likely say no but it was worth a try. "No. I won't let you do to my patient what you did to my Mustang. You really think I would let you scrub in? I don't think so." Derek bluntly replied.

Meredith stared at him, surprised.

Why was he treating his sister like this after pushing her to build a relationship with the sister she never knew she had until a few months ago? God, the hypocrisy. Amelia didn't say anything, she rolled her eyes and left then. Meredith watched her go and then turned to face Derek. This couldn't go on like this, at some point he'll need to forgive her. "Derek, she's your sister." Meredith looked at him confused.

"She totaled my car. So no, I don't trust her in my OR." Meredith shook her head.

She glanced at him for a moment before replying.

"I totaled my mom's car. She was angry at me for doing that but she was relieved that I got out with this with only minor injuries. You're being like this because she totaled your car a few years ago?" Meredith asked, she didn't understand why he was acting like this. "People make mistakes."

"When you totaled your mom's car, were you high on pain pills?"

Oh, no.

Meredith thought, hoping this wouldn't be what she thought it was.

"No." She answered truthfully. Besides the meds she needed to take, she'd never taken anything else because of the fear of adverse effects. "Did you steal your mother's prescription pads so you could feed your addiction?" Derek asked her. He wanted her to understand. He did all this because he was scared to lose her so he keeps pushing her away. But they couldn't know that. Amy. Meredith. Meredith would understand, for sure. But he ...

Slowly Meredith seemed to see Derek's point of view. "She stole your prescription pad?" Meredith exclaimed loudly.

That was a very shocking revelation ...

Silence.

But only for a moment.

Derek's face was still unreadable.

But Meredith knew he must be hurting inside, reliving this. Maybe that was because he wouldn't want to speak with her. Meredith was sure about that. That must be the root of it. In this moment, she promised herself she'd make things right with Lexie. She seemed like a decent girl. She should call her. This is what sisters do, right?

They talk and tell each other things.

"Yeah, she did. And when she came home, she OD'ed. She was dead for three minutes, I saved her. That's what she put my mother through after losing my father and raising five kids on her own. So no I don't trust her in my OR." Derek said bitterly and left. Meredith stood there. Frozen to this spot. From what she just heard about her soon to be sister-in-law.

* * *

An hour later they were ready and prepped to go. They were going to attempt to remove the entire tumor if safely possible by using a minimally invasive endoscopic endonasal approach because it's recommended in Brianna's case. It also reduces the risks of hypothalamic injury. "What's the difference between treating adults and children with this condition?" Derek asked Meredith as they were both scrubbing in on Brianna case. Arizona Robbins was already in the operating room, watching every move the anesthesiologist and additional personnel made. She'd taken a special interest in this case and nobody knew why.

"We haven't really talked about what neuroendoscopy is ..." Meredith took that as a hint to explain.

She drew in a deep breath before exhaling.

"In adults, doctors often use a more conservative approach, they are aiming to establish a diagnosis and decompress the optic nerves, but not necessary attempt full removal of the tumor. Because the tumor almost always involves the pituitary stalk, attempting to remove the entire tumor carries the risk of damaging the pituitary gland, leading to complete pituitary insufficiency." Meredith answered.

"Neuroendoscopy is a minimally-invasive procedure in which the tumor is removed through small holes in the skull or through the mouth or nose. It enables neurosurgeons to gain access to areas of the brain that cannot be reached with surgery and removing the tumor without needing to cut or harming other parts of the skull." Meredith said. "Good." Derek simply said.

The neurosurgeon finished scrubbing in and walked into the operating room.

Meredith looked at him for a moment and smiled as she saw the ferryboat scrub cap on his head. He loves wearing that scrub cap ...

And she liked watching him operate.

He just looked so sexy at practically everything he does.

Meredith followed soon after that, joining them. Soon, they were able to start. The young girl was placed under general anesthesia and intubated. Meredith watched the nurses and other medical personnel forming a crowd at the right side of the operating room.

They were using an endoscope that was equipped with a high-resolution video camera and eye piece on the end to allow the Derek to navigate and access the tumor. Derek and Meredith both watched the monitors, the screen on where it recordings of the high-resolution camera are displayed. It was very interesting. Meredith was learning a lot and sometimes Derek even explained some things. It was a nice difference to being asked questions. But of course she had to do those things as well.

"Can you tell me the benefits of neuroendoscopy?" Derek asked while navigating the scope, he was very concentrated-

"Well, there is the pain factor." Meredith started.

"Using this method has the advantage of less pain than traditional surgery and also, a aster recovery than traditional surgery has been reported. Also, there is only minimal scarring. So this is why ..."

Meredith looked at the display. They were now there, she could see the tumor easily. They were now starting to remove the tumor and take a sample of it and send it to the lab to confirm the diagnosis, they attached special instruments to the endoscope, in this case, an additional endoscope with forceps and scissors on the end.

"Now silence this is the hard part." Derek said.

Immediately, everybody quieted down.

"Bone graft is in …" Callie Torres said as Meredith and the other residents were watching every move Callie, Derek and Mark were doing. "… and we're done." She completed the sentence. "… east down on the retractor …" Dr. Burke said as Meredith did exactly what he wanted from her. He was the leading cardiothoracic surgeon on this case, Derek was responsible for the neuro part and Callie was responsible for the orthopedic part of the surgery, hence the fact that she's an orthopedic surgeon. Cristina was staring at the monitor to make sure everything was as it should be.

"Shepherd, how are we?" Mark Sloan asked, directing his question over to Derek who was still working on getting clear margins.

"If I can get a little further, the margins will be close to perfect." Derek said, fixated on what he does. Then after some seconds, he said suddenly: "Hold on." He stopped what she was doing and looked. "Can you advance the scope?" In that moment, the heart monitor went crazy and everyone in the operating room looked up. Oh no, this was not supposed to happen, not this little girl. "Damn it." That was Mark as he realized the extent of the situation they were in. "What the hell happened?" Burke exclaimed loudly as he glanced at the cardiac monitor. Her sats were falling and she was tachycardic. "We hit the carotid, I can't see a thing." Meredith's heart was beating faster as she realized that the patient was bleeding and that fast. They needed to be fast in order to do something about it. "Sloan, suction." Shepherd told him harshly. Oncoming panic eroded and the monitor was still beeping too fast.

"How can we help?" Meredith asked, her instincts were kicking in now.

"Do as we say." Derek said in a stressed tone. "You can press this artery. Grey, I need more suction." That was Mark.

Meredith did as was asked. Derek asked for another suction to be set up. She was losing way too much blood. Blood was coming out of her mouth. "Damn it she's gonna bleed out if we don't get this bleeding under control soon."

Suddenly they were all talking at the same time, yelling that her blood pressure was falling.

But luckily, after some time, they got the situation back under control. "Now that was scary." Arizona said as she watched the heart monitor. "You tell me." Derek replied after taking a deep breath. Then he continued on with the surgery. After successfully ending the surgery, all the surgeons scrubbed out. Derek was the man surgeon and therefore he was the one talking to the parents, along with Arizona and Meredith. He asked a nurse where he could find Brianna's family. "They're in the waiting room." The nurse pointed him the way.

"Thanks." Derek replied before making his way to the waiting room.

He remembered being in the same position. Hours. Hours that didn't seem to pass. Doctors who have to deliver bad news to relatives - that there was a complication, that despite their best efforts, the patient died ... the list of number of things that could go wrong in surgery is endless. Now he can't stop thinking about Meredith's heart surgery and how the wait has affected him. Normally, he did not think about it but now? Somehow this case was hitting more close to home than others. He tried to clear his head because now they were entering the waiting area and Meredith immediately spotted the girl's parents sitting there on their chairs, nervous ... about what could happen next. Derek and the other doctors walked toward them. They got up immediately. "You are the surgeon right?" The mother asked, worried.

"Mr. and Mrs. Davidson. I'm Dr. Shepherd and I performed the endoscopic tumor removal on your doctor." That's what he was able to say before they started asking questions without any pauses between them.

"Is she okay?"

"How is she doing?" Tons of questions ... He should have known that ... He should have. "When are we able to see her?" Derek breathed in quietly before looking over to Arizona who took over. They were planning on doing a MRI scan on her, those are typically obtained immediately postoperatively meaning within 48 h after the procedure, then at approximately 3 months as aftercare, and annually thereafter. Long-term follow-up also includes visual-field and pituitary hormone testing. That's what she told the parents who were just glad that she made it through surgery after hearing about the complications that had arisen in the middle of the procedure."

"She's in post-anesthesia care unit and will be cared for there until the anesthesia wears off. Then we'll move her to the pediatric intensive care unit after doing some post-surgery evaluation like doing full postoperative endocrine evaluation as well as repeated imaging studies." He knew that this was advisable in this particular case.

"Derek." Meredith called his name.

"What happened?" She asked, wanting to know about the incident that just happened in the waiting room. "Or why happened it?" She asked, mildly concerned.

"It's nothing, Mer." He said a bit gruffly.

"You stopped in the middle of a sentence, you never did that before when talking to patients."

"It's nothing." He repeated, his voice warmer than before. It wasn't Mer's fault that he now keeps thinking about Meredith's surgery.

"Derek, we all have those patients. Patients who undergo procedures and where complications occur. That was a complication. It wasn't your fault." Amelia tried to tell him. She'd asked the Chief of surgery if she could get privileges and watch the surgery in the OR gallery. He even allowed her that even if Derek wasn't so elated about it. "Amy ..." Derek said, wringing his hands nervously. "I'm taking that as a cue to leave." Meredith said.

"See you at home, Derek."

Derek watched her go. He kept thinking about lifeless, pale Meredith laying in that bed in cardiac intensive care unit. It was constantly penetrating his brain. He heard Bailey telling him that she might not make it. Amelia watched her brother's face expression. It was clear he was thinking about something that happened months ago and that was still scarily real for him. She couldn't shake that feeling that it had something to do with Meredith. "Derek." Her loud voice snapped him out of his stupor. "Derek. You okay?" She asked, touching his arm. "I'm fine." He hissed at her. Amelia tried not to take it personally. "Amelia?!" A voice startled them. Amelia turned around only to face Mark Sloan.

"Mark Sloan." Amelia exclaimed, while grinning broadly. "Is that you."

"I have to go." Derek muttered irritated. Amelia gazed at him before focusing on Mark. They had a lot to talk about. "It's been years since I last saw you. How have you been?" He grinned at her as they shared a hug. "Great. What about you?" "Well, you look ... way more grown-up than the last time I saw you."

"Aw, come on, you can say hot 'cause I am."

Mark shook his head. "I can't say that because you're still Derek's twelve year old sister." He reasoned ...

Later that day, Meredith came home late. She needed to finish her post-op notes and had a million charts to update. Now that Izzie was on probation and currently not at work, they had more work to do. She was so tired when she finally was home. "Ugh, tired. Hate night shifts." She muttered under her breath. It was already midnight. Derek was probably asleep so she tried to be quiet. Soon she was dressed in her night clothes and climbed into the bed, reaching for the warm blanket. But before she went to sleep she kissed Derek softly on the forehead, hoping he wouldn't wake up. He didn't. Subconsciously, Derek put an arm around her waist and Meredith reached for the blanket, making herself comfortable.

She smiled, knowing that she would get a goodnight's sleep although it was now even later. At some point she just closed her eyes and slept. Derek's body was keeping her warm.

* * *

The next day, Derek's family was still in Seattle. They were planning to stay for a few days, maybe up to a week. But they could change their flights back if necessary. Meredith was dealing with it. Yesterday's case had been intense. It was always so much harder with children. It always was. She was about to meet them for dinner in the hospital's cafeteria. But they hadn't shown up yet. Meredith didn't mind waiting. Derek was stuck in surgery, leaving Meredith to deal with his bunch of sisters. But ever since Derek had set them straight, Nancy was acting civil. Meredith didn't about what the others felt about her. She honestly had no idea.

Meredith was talking to Carolyn. She told her that Derek would be awhile since he was stuck in some emergency surgery. He had no choice but to scrub in on that surgery. Meredith knew that and she was sure that the majority of the Shepherd clan would get it as well. Normally, she'd be with him in surgery or in the gallery watching if there was nothing else for her to do. "Dr. Grey." Burke said her name, his brows furrowed when he saw that she had company what he presumed to be Derek's family. So he was trying to as casual as possible and not letting on what that means. When they all turned up, they turned to go to cafeteria to get coffee. But then she saw Dr. Burke hurrying between different rooms. When he caught view of Meredith he called out. "Grey, it's good that I catch you." Meredith realized what he was talking about. Damn it, she really should have remembered. "I can fit you in at 11:30 tomorrow." For your pacemaker follow-up. But he didn't say that.

Meredith was grateful for that.

He probably knew that she wanted to keep this quiet as long she could. She wanted to hide from Derek's family. Who knows what they would think if they knew that she had a pacemaker, that's she is being treated for CHF due to a CCHD. Who knows what they would think. Meredith shook her head in thoughts. "Does that mean you have time or not, Grey?" His voice sounded slightly impatient. Meredith snapped out of her thoughts and diverted her attention back to what happens in real life. "Uh, 11:30 is perfect. I'll be there." Meredith stammered, taken by surprise.

"Ok, I'll see you then, Grey."

Meredith swallowed before she turned back to Derek's family who watched her interaction with Burke interested. "So what was this about?" Nancy was the first one to speak. "You're not cheating on him with that guy, are you?" Nancy was once again acting bitchy. Meredith was tired of it, and also that she was always sticking her nose where it doesn't belong. "What the f**k are you saying? I'd never cheat on him. I'm not ... You are crazy when you think that. No, I have a thing. That's medical related. I need this thing to get checked out regularly. Not that's it your business because it's not, frankly." She was enraged. How dare she say that. "Nancy." Kathleen said warningly as she shot her sister a bity glance.

"Does Derek know?"

"Of course he does. I'm pretty sure he would drag me to those appointments if I missed them. So, yeah, he knows."

He knows indeed about her crappy heart.

"It's that important?" Nancy asked back, shocked at Meredith's response. Amelia watched the young doctor and he face expressions she made. It was clear that it was uncomfortable for her to be talking about those things. She knew Meredith was hiding something and she was sure that that appointment is part of it.

"Yeah, actually it is. Not every baby is ... never mind." Meredith shook her head.

"Guys, we don't we go down to the cafeteria. Meredith wanted to take us there anyways. So let's do that." Kathleen sugggested so that her oldest sister would stop interrogating Meredith.

She should really learn when not to pry into somebody else's life.

"That's a brilliant idea."

Carolyn smiled and turned to Meredith. "What do you say, dear?" She asked her. "Yeah, sure why not." She answered.

* * *

An hour later: "Oh, crap." Meredith suddenly said as she looked at the time. The others were talking about some of Derek's nieces and nephews. "Damn it, I forgot. I'm sorry but I have to go." Meredith stammered while jumping up from her chair and hurrying away. Only minutes later, Derek joined his family in the cafeteria. He looked around, seemingly searching for Meredith. "Where's Meredith, have you seen her?" Derek asked his mother. "She had some appointment she couldn't miss. She seemed very nervous about it." What set this off? An appointment? Mer? Oh, right. _That_. Derek was surprised. But when he looked at the date and time, he instantly knew why Meredith had been acting like this. He sighed, wanting to accompany Mer in case she received bad news. He desperately hoped that it wouldn't be the case. "Derek what is it? Ever since Meredith stormed off, you seem different, I can really describe it but you seem changed." His mother noted the changes.

"Yeah, I know. It's just that I promised Mer I'd be there for this thing."

"What thing?" His mother pressed softly. His sisters were looking at him expectantly. "All this secret-y thing is weird." Amelia added in.

Meredith hurried to the exam room where she was supposed to meet Dr. Burke. She hoped she wouldn't be completely late because that would be embarrassing. It was now 11:35. Crap, she was indeed late. She panted as she reached the room but soon she saw that she hurried without having a reason to hurry. Burke was apparently late as well. But before she could end that thought, Burke appeared in the hallway, her patient chart was in his hands.

"Grey, there you are. I thought you'd blown me off." He said, half joking.

Meredith looked to the ground.

"I … did not blow you off. If that were to be the case, I wouldn't be here right now." Meredith replied."I'm not that irresponsible despite what you may think after the crap I pulled."

Burke's eyes went wide went he heard her choice of words.

"The crap you pulled? Define crap, Grey."

Meredith cleared her throat. "The 'not telling anyone in this whole about it'-thing, the 'escaping from the CICU'-thing ... the list goes on. Don't forget the pneumonia, Burke." He laughed. "But we got that figured out, don't we? But you're right it could have ended differently."

"Yeah, it really could have. But what are odds, right?" Meredith said. "In the end everything comes different anyways, so screw the odds. I keep beating those odds anyways."

"Let's get started, shall we?" He then asked his patient, motioning her to hop on the gurney so that he could perform the exam. After he told her to expose her upper body he turned around, scribbling something unreadable into her patient chart. Then he said: "I'll be right back. I have something I need to organize." With that he left the exam room.

Meredith was now sitting on the gurney, waiting for her doctor to turn up again. Meredith inhaled and exhaled slowly, trying to calm her nerves. This was always hard on her, not knowing if there was something that indicated that she would need intervention again. Then she reached for her pager, she thought about sending Derek a quick message that she has the follow-up exam to control the position of the pacemaker leads, if the pacer is pacing the way it is supposed to be pacing. But maybe he was in surgery and knowing that she was about to undergo a medical procedure wouldn't really help him concentrate. And that's why Meredith decided to put the pager away.

She leaned back.

She was trying to relax but the big poster on the wall featuring a human heart wasn't really helping. **THE HUMAN HEART **was the headline. Then the heart and some explanations about preload and afterload and the physiology of the heart and about the electrical conduction system of the heart …

That it has four chambers (that are supposed to pump efficiently blood to the lungs and body) ..

Two ventricles and two atria as well as four heart valves ...

Meredith turned her head away. The ultrasound machine was standing next to the gurney as well as the computer that's recording the patient's heartbeat on paper. She was thinking about her upcoming wedding and how they need to start organizing it. She wanted it to be small, only family and close friends and maybe a small celebration after that. But nothing really big … she was not the type of girl who likes that kind of thing. The door opened abruptly and she came face to face with a shocked and ashamed nurse who quickly apologized.

"I'm sorry for this-. I didn't know this exam room is occupied. I … I am sorry." She stammered.

Meredith sighed before replying: "It's ok." After nurse quickly left the room, she leaned back and closed her eyes. Where was the cardiothoracic surgeon? Wasn't he supposed to be here by now? Meredith was confused, how long is this gonna take? But then, a few minutes later Burke reappeared. "So, Grey, I see you're ready to start now. Here is what we are gonna do today: you are scheduled for a chest x-ray later today and we'll also take your blood and send it to the lab. The rest is pretty much routine. I will do the ECHO, then the electrocardiogram and pulse oximetry." Meredith glanced at him. He was clearly acting like a professional doctor.

"So we're doing a chest x-ray?" She asked.

"Why?" She then added.

"We are doing this to check the position of the pacemaker leads if there are any concerns."

"You want to check for ..." Meredith inhaled deeply. "Right, how could I have forgotten that?" She mumbled under breath. He reached for his stethoscope. "I will start by listening to your heart and lungs. Take a deep breath for me?" The stethoscope was feeling a bit cold on her skin and when it came into contact with hers she flinched slightly at the cold. "You okay?" Burke asked. "It's just cold." Meredith answered. "I'm fine."

"Do you want me to wait for Derek?"

He looked at her expectantly. "No, just get started. I'm pretty sure you have a lot more to do than doing the follow-up with your intern patient." Meredith replied while rolling her eyes. "You have a serious heart condition, Meredith. You need lifelong follow-up care even if you don't like it."

"Don't you think I know that?"

"Now that you have a DDD pacer you need to get checked every six months."

"You're kidding, right?" Meredith groaned.

Perfect.

This was just perfect.

* * *

**A/N: Yay, I finally came around to write the next chapter. Anyways, I hope you like it.**


	51. Chapter 51

**Chapter 51**

* * *

**In order to properly treat a problem, a surgeon needs as much information as she can get. So we ask questions. Things like when did the pain begin? Have you experienced these symptoms before? Do you have a family history? Are you currently sexually active? Have you recently undergone surgery? If you're unwilling or unable to answer these and other questions, we're forced to rely on tests for insight. Until those test results come back, there's nothing we can do but next time you're in your doctors office, remember she's not asking all those questions for her health. She's asking them for yours. Tell her everything. The small details aren't trivial. They actually make the story. There's no rush, take all the time you need, start at the beginning.** Meredith Grey; Things We Said Today

* * *

But then, a few minutes later Burke reappeared. "So, Grey, I see you're ready to start now. Here is what we are gonna do today: you are scheduled for a chest x-ray later today and we'll also take your blood and send it to the lab. The rest is pretty much routine. I will do the ECHO, I will take your blood pressure, then the electrocardiogram and pulse oximetry." Meredith glanced at him. He was clearly acting like a professional doctor. "So we're doing a chest x-ray?" She asked. "Why?" She then added. "We are doing this to check the position of the pacemaker leads if there are any concerns." "You want to check for ..." Meredith inhaled deeply. "Right, how could I have forgotten that?" She mumbled under breath. He reached for his stethoscope. "I will start by listening to your heart and lungs. Take a deep breath for me?" The stethoscope was feeling a bit cold on her skin and when it came into contact with hers she flinched slightly at the cold. "You okay?" Burke asked. "It's just cold." Meredith answered. "I'm fine."

He is not saying '_you're always fine and that's the problem_.'

He didn't say that. "Do you want me to wait for Derek?" Dr. Burke asked her.

He looked at her expectantly. Meredith shook her head."No, just get started. I'm pretty sure you have a lot more to do than doing the follow-up with your intern patient." Meredith replied while rolling her eyes. "You have a serious heart condition, Meredith. You need lifelong follow-up care even if you don't like it." He glanced at her firmly.

"Don't you think I know that?" Meredith gave back, slightly annoyed. He was talking to her as if she didn't know that. But she does know that. She's known since she's gotten to know about her defect for the first time. They said it was essential for her to keep going to those appointments so that they could catch possible problems early on. Meredith hadn't really listened to them at that point. That was during her 'dressing in black and coloring hair pink'-phase. She didn't want to think about that. "I know that I need that. I know that now. I've grown up, I'm no longer the angry, pink-haired teenager who ..."

_I didn't just say that, right?!_

"Grey, I'm aware of that, believe me." Dr. Burke calmed her down.

"Now that you have a DDD pacer you need to get checked every six months."

He had to remind her of that. It was really important. On Meredith's face he saw that she hadn't seen this coming. Or maybe she had but she wasn't prepared for it. She looked aghast.

"You're kidding, right?" Meredith groaned.

Perfect.

This was just perfect.

But Meredith saw that he wasn't kidding. Burke wasn't the type of man who was kidding about such a serious matter. He wouldn't. So that's as clear as mud. Meredith knew that. Of course did she know that.

Meanwhile, Burke was gazing at her, and she was listening to what he says.

"I'm not doing this just for fun. This is medically necessary. That's the reason I want to see you here again in six months, considering there aren't any problems occurring. If there are problems, don't hesitate. Come and find me, I'll do an exam." Dr. Burke looked at his patient, hoping she would understand the seriousness coming with this. "Yeah, I understand." Meredith finally replied. What choice did she have? There wasn't a choice to make.

"Now that we've discussed that problem, I'll start with the ultrasound." Dr. Burke turned around and made a quick notice in Meredith's charts before reaching for the transducer.

Meredith simply stared at the ceiling and didn't respond in any way, at first. But then she gave him the go ahead. Dr. Burke sighed and asked again: "You sure you don't want Derek here?" Meredith answered: "You can start. It won't change the outcome anyways." "But he can be there and comfort you if something goes south." Meredith stared at him before saying: "You don't seem very optimistic, Dr. Burke." Her voice shook slightly. "Should I prepare myself for something bad?" Dr. Burke put the transducer aside and cleared his throat. "You are right, I wasn't very optimistic when I first saw your scans and ECHO results but now that you've undergone surgical correction of the aortic valve and a pacer that stimulates both atria and ventricles, I'm cautiously optimistic. But let's see what the ultrasound says." He finished his talk. Meredith breathed in before laying down in the right position, she wasn't laying on her back, she was laying on her side, face to the wall.

The room was only dimly lit so that the focus is on the ultrasound screen.

"This is gonna be squishy and cold." He warned her, the gel landing on Meredith's chest and started with the apical four-chamber view. He placed transducer on the fifth intercostal space, aproximately left midclavicular. The transducer's index mark is directed towards the patient's left side. Her left and her right ventricle, as well as the left and the right atrium were displayed on the screen. It was a heart. A real heart that was beating in front of him, normally not so big a deal …

But this was different. Then again, this was Cristina's person.

Meredith could hear the faint _whoosh whoosh_ in the room. She knew it was the sound of the valves as Dr. Burke looked at them switching into M-Mode. This view is used to measure the width of the aortic root, the separation of the aortic cusps, and the anteroposterior dimension of the left atrium. The M-Mode can be performed from a long or a short axis view. Whichever view he used, she made sure that she aligned the structures perpendicular to the M-Mode. This is done by adjusting the 2D image plane as well as the M-Mode line. He also scanned all the other valves using the M-Mode technique. Time didn't seem to pass at all. Meredith felt the pressure on her chest coming from the transducer Burke was pressing against her chest.

"Is the pressure ok?" He asked, glancing at her briefly.

"Yeah, sure it is fine. Carry away." Meredith retorted, closing her eyes, ignoring the steadily beating heart on the monitor.

In this moment, someone hammered against the door. "Come in." Burke called out, taking the wand away from Meredith's skin. He turned toward the door, half expecting some nurse to come in.

But it wasn't. It was the neurosurgeon attending. Derek rushes into the room, was late. "I'm sorry I'm late-" He panted. Dr. Burke turned around only to see his colleague standing there in the door. Dr. Burke eyed him. The image of Meredith's heart frozen on the screen. "Hey, I know, I am late. I am gonna make it up to you, I promise." Derek smiled at her. Burke closed the door behind Derek as he took place on a chair next to the gurney, facing Meredith who had a tiny smile on her face- "You made it." She whispered. Meredith smiled at the sight of her soon to be husband. He hadn't broken his promise to be there after all. He was here and that is what counts. Derek gave her a quick kiss on the forehead before turning to Burke.

"She's okay, though? Nothing pathological …?" Dr. Burke shook his head. "From what I have seen everything seems fine. But I haven't started with the echocardiography yet. So let's get started shall we?" The room was only dimly lit so that Burke could see the pictures better.

"He also wants to do a chest film." Meredith added.

"Why do you want to do a chest film? You don't think there's something wrong, do you?" Derek said panicked at the mention of something being wrong. "I want to check the position of the pacemaker leads." Dr. Burke replied. "That's it."

"Good. You had me worried here for a sec."

Then he turned the transducer. The left ventricle and the left atrium are shown on the monitor. He took a deep breath as she moved the transducer to next position. It was definitely easier to do this on some random patient than on someone he knows. Derek was trying to glance at the monitor but since Burke had turned it so that he wouldn't see it. "Can you turn the monitor a bit?" Derek asked, hoping he would yes to that. "Why do you want me to turn the monitor?" Burke asked back. "Please just do it." Derek breathed audibly. "Derek. Let him work." Meredith murmured softly, "He'll tell us whe he finds something.

"But I'd feel better if I knew for myself there aren't any problems." Derek reasoned.

"I'm very capable of evaluating this ultrasound, Derek. I don't need a second set of eyes." Dr. Burke said. "You sure are but would you please turn the screen a bit?" Derek repeated his question.

"Fine." He said resigned, giving in.

The cardiothoracic surgeon was highly concentrated when he looked at the heart in the apical four-chamber view. The transducer is placed above the apex cordis. He pointed the nose of the transducer to the left shoulder. The scan view runs towards the heart base. Thus, the left ventricle is right-sided. The transducer is tilted by Dr. Burke anteriorly toward the aorta thus also tilts to scan view. Now the beginning of the aorta ascendes, left ventricular outflow tract and aortic valve can be seen on the screen. Burke looked at Meredith's heart in the apical five-chamber view. Derek glanced at the monitor, seeing all four chambers and the left ventricular outflow tract.

He enlarged and reduced the image to get a better view to see if something is wrong.

"There is still a residual defect. It's minute but there. Right now it's not causing any problems you might need to think about VSD closure via catheter. So there wouldn't be a major surgery associated with it." He told her.

Meredith frowned.

"Why haven't you closed it during surgery?" She asked. "I mean it would have made sense to close it with a patch before problems arise. You know me. This will end badly again." Meredith shook her head in denial although the news weren't very surprising. She knew she had a residual defect. Dr. Preston Burke measured something with a line to see how large the hole in the interventricular septum is. She sighed loudly. Derek swallowed.

"So we don't need to close it unless it causes problems?" Meredith wanted to know for sure.

Dr. Burke nodded.

"Okay, I can live with that."

"Now I also want to calculate the LVEF and ..." He announced.

"... right ventricular ejection fraction." Meredith ended his sentence. "Moment of truth. Now you get to see how dysfunctional my systemic ventricle really is." Meredith muttered, pessimistic. "You want to find out her ejection fraction." Derek reached for Meredith's hand pressed it slightly. "Of course he wants to find out. Measuring the EF is an important part of ... this." Meredith told him, kind of rambling. "We all know." Derek said. "This why he estimates it. Because it needs to be done." While Meredith and Derek were discussing the pros and cons of finding out her EF, he started calculating it using quantified volumetric measurements even though it was time-consuming. He estimated it based on the overall size of the RV and LV chamber, the contractility and the thickening of the heart walls as well as the decrease of chamber size in systole.

"Tell me something, Derek. It doesn't matter what just tell me something." Meredith looked at him pleading.

"Uh, what do you want to hear?" Derek asked, he just hadn't expected that.

"How did you do it?"

"How did I do what?" Derek asked back. "Growing up with four sisters? Or why do you like the outdoors?" Meredith replied.

"Oh you mean that." Derek laughed. "Honestly, I don't know. I had Mark. We did all kinds of stupid things together. I've practically known him my whole life." Meredith gazed at him with big eyes.

Derek continued, noticing that talking relaxed her. She wasn't even paying attention to what happens. "I was closest with Amy. She's younger than me. My other sisters are all older than me." "You were closest with ... then why aren't you ... never mind. Go on." Meredith looked at him. "When I was little, my father used to take me fishing so that we could get away from the girls, mostly on the weekends since we lived in a small suburban town. The nature was too far away to do it more often. Of course we didn't do it every weekend. But I loved it. Us, in a small boat, and fishing and the sleeping in a tent on hard ground ... Away from everything. That's why I love doing outdoorsy activities."

"I see." Meredith smiled. This helped.

"So, Meredith, I've estimated your EF." Dr. Burke was now talking to his patient.

"Just tell me straight out." Meredith looked at him, waiting for his reply. Derek fell silent. "Your EF is 50%. That's an improvement since previous results." He told them. "So that's good." Meredith slowly replied, not quite believing it. It wasn't normal but it was okay. She could live with that.

"Mer, that's great." Derek gushed overjoyed, remembering the time before and shortly after surgery.

Dr. Preston Burke removed the transducer from Meredith's chest after he saw her heart in all possible scan views after he also completed the standard measures with M-mode. It is a Time-Motion method and happened to representation of the echo of a continuous time. There are precise measurements of the end-diastolic and end-systolic strength of septum and Posterior wall, end-diastolic and end-systolic ventricle diameter possible.

They also did the short-term electrocardiogram and the stress electrocardiogram to see how her heart responds to stress. Before the stress test Dr. Burke wanted the pulse oximetry done. "Ok, no, that's a false result. Let's try that again." He said as he saw that the test showed a number that couldn't be right. "Do you have cold hands?" Meredith only nodded. "They need to be warm to get an accurate result."

"Derek always has warm hands." Meredith mumbled.

Only Derek could her it and that he took as a cue. His hands closed her hand. After some time Dr. Burke decided to retry. And this time it worked. "Pulse ox is good." He then said. After the other tests were through, they did the chest x-ray. When they were finished, Burke started reviewing it while Meredith and Derek waited. The cardiothoracic surgeon saw that this was a normal chest film with a dual chamber pacemaker. The atrial lead curved upward in a_ J_ to reach the atrial appendage. The right ventricular lead ends in the ventricular apex to the left of the spine which was ideal. "So everything checks out okay." He then said.

Derek breathed a sigh of relief. "So we just need to take some blood and we'll be done." Meredith's face clearly showed Derek that she didn't want to. It felt cold when Burke disinfected her skin. Meredith flinched at the sight of the needle. She felt a sharp pinch when the needle entered her skin. "Hey, it's okay." Derek whispered, he was aware of her needle phobia. "I just don't like needles."

"You're a doctor, Grey. Why are you scared of needles?" Dr. Burke interjected. "That doesn't mean I have to like needles." Meredith gave back, huffing. "Are you scared of needing cardiac surgery at some point?" Meredith asked back. Burke looked at her blankly. "That's different." He only said. "Oh, is it?" Meredith asked. "Yeah, it is." He only said. "So you are scared." Meredith stated. "I don't think that's your business, Grey." "Neither is my needle phobia yours." Meredith answered. "Oh are we being feisty?" Derek smirked at her. Even Burke turned his head to him.

Meredith glared at him.

"Shut up, Derek." He just laughed.

After some time, Burke was done. "So, I'm all done." He said. "Mer, did you hear that? He's done poking you with needles." Dr. Burke watched the verbal exchange between his intern and fellow attending amusedly.

"You just have to wait for the lab results." He said afterwards.

"I know." Mer replied. In this moment his pager beeped. "I have to go, there is a code blue ..." That's when Dr. Burke stormed off, leaving to help get the situation under control.

Meredith and Derek were standing outside the exam room after the exam was completed. "You did those things with your father. It reminds you." That was a statement. Derek nodded. Meredith seemed to think about what to say next. "That would be a great thing for us to pass onto our children." Meredith noted, immediately feeling Derek glancing at her. "If you want to have children at some point ..." She then added. "You think so?" Derek's eyes lit up.

"Better don't get your hopes up, Derek. I don't know if I can support a pregnancy."

Derek stopped. He hadn't really thought about what it meant for Meredith. He hadn't. "Maybe we should've talked about this with Burke." He muttered. "Even before we have talked about it? We need to talk about those things first." Meredith said. "You're right." Derek agreed. "We'll figure this out, Mer." Meredith stopped and looked at him. She really loved this man. "You should go be with your family. I'm sure they would appreciate some time alone with you." She smiled sadly.

"Meredith." He said her name. "Derek, don't." She told him.

"I have to work anyways. I just took the morning off because of this ..." Derek sighed as he watched her go. "Mer, wait." He called and ran after her. Derek, what …" But before she could end the sentence, Derek pressed his lips onto hers and before they knew they were in the middle of the hallway, kissing. For a moment, it was only them. Then Meredith broke the kiss, smiling slightly before saying: "I love you. But as much as I want to spend the day with you, I need to work."

* * *

The exam had been okay. Now she has to wait for the results to come back. They've also taken her blood. It seemed like it, the exam itself, had taken hours but it hasn't. She went looking for Dr. Bailey. Maybe she has something to do for her. Meredith saw Mark standing there, talking to Dr. Stevens about a case. "Dr. Sloan, have you seen Bailey?" She asked as he turned to her. "Ah, my favourite dirty ex-mistress." He smiled mischievous. "Don't let that hear Derek." Meredith laughed. "I will be on the ground bleeding when he hears me say that believe me." Mark said. "Yeah, I've seen here at the nurses' station, going through some charts." He said. "I haven't seen you all morning, where were you?" He asked. Meredith said: "I was getting my cardiac follow-up. They now have to do it twice a year. Twice, Mark. Not once, twice." Mark chuckled at the way she said that. "But you can't really help it, can you?" He asked. "No, I am afraid not." Meredith sighed. She knew this was necessary. "Then I'll be on my way finding Dr. Bailey. I'm sure she has things to do for me so that I can avoid the Shepherds a little longer." Meredith saw the smirk on Mark's face.

"They've giving ya a hard time, huh?" He asked, eyeing her. Meredith confirmed that question. They did. "So what are you doing now?" Meredith asked. "We're about to do a rhinoplasty." He said.

"Uh, fun." Meredith said.

"At least way more fun than waiting on your labs to be delivered. But seriously, have you seen Bailey?"

Mark shook his heart, refrained a laugher. "I just told you that, like a minute ago. She's doing charts at the nurses' station." "Okay, thanks, Mark." With that, Meredith left to find Dr. Miranda Bailey who was indeed updating charts at the nurses' station. Meredith cleared her throat to get Bailey to notice her. Dr. Bailey looked up briefly before going back to charting. "Dr. Bailey." Meredith said. "What is it, Grey?" "I need an assignment." She said. "You don't. Take the day off, I hear the Shepherd family is here. Why don't you use this day to get to know them a little better, huh?"

"Dr. Bailey, I think I'm perfectly fine to work." "You're always fine. That's your problem. Also, besides the fact that McDreamy's dreamy family is occupying the halls of this hospital you had your half-year check-up which leads me to expect that there is a certain level of distraction to be expected today which is why I'm ordering you to take the off."

Silence followed.

Meredith gaped at her with an open mouth.

She couldn't understand why she was supposed to stand back and let others do the work she was qualified to do. "Why are you doing this? Just because I had my follow-up today it doesn't mean I am not capable of doing my work. With all due respect Dr. Bailey, I don't think this is necessary." Meredith questioned her decision. "It's not your place to question my decisions. Grey, spend time with the Shepherds. I got you covered. It has nothing to do with your follow-up appointment with Burke. Just take it as is, Grey." Her features hardened when she said that. Meredith rolled her eyes. "Fine, I'll do what you ask." She murmured. "Grey, wait." For a moment, Bailey's features softened. "How was it?" Meredith avoided the question.

"You mean my follow-up?" She asked, biting on her lip.

"That bad?" She asked softly. Meredith shook her head. "It was okay actually. Not great but also not bad. My pacemaker's definitely working and my EF is 50%. That's almost normal." Meredith smiled. Dr. Bailey smiled at her intern. "That's great, Meredith." She then said.

"I mean, it was like 36% before surgery. It really went up." She couldn't help but smile. "Now I'm waiting for my lab report to get back since Burke drew some blood." Meredith added. "Which is why I need to work-"

"Grey." Dr. Bailey said warningly.

"I got it." Meredith turned around and walked away. When she rounded the corner she stopped. She really didn't like this day. There was nothing about this day to like so much was clear.

But then, she felt someone standing next to her. Reluctantly, Meredith turned around only to be faced with the youngest Shepherd. "Hey, Meredith, what are you doing here all alone?" She asked, sounding interested in her – for real. "I, uh, have nothing to do. My resident gave me the day off. I don't even know why. Apparently, there's a certain level of distraction to be expected, meaning I can't be working right now given the circumstances." She repeated what her resident said.

"What?" Amelia reacted. "She's not letting you work? Why? Did you accidently kill someone?" "Shut up." Meredith asked. "Geez, but why isn't she letting you work?" Amelia answered. Meanwhile, they both walked outside. Outside the hospital, a cold and strong wind greeted them both. Involuntarily, Meredith shuddered. Meredith felt Amelia's glance lingering on her.

"Have you met Bailey? She doesn't take no for an answer." Meredith defended herself.

"You mean Bailey? She's your resident? I know even Derek is scared of her." Amelia exclaimed chuckling. She didn't wait for her reply, instead she just kept talking about something: "I remember how my residency was. I was tired, practically all the time. But still it was great. My resident was very … how do you say?"

"Difficult?" Meredith offered, showing a half-smile.

"You could definitely say that." Meredith waited for her to finish.

"But once you get to know her, you know that she really cares about the well-being of her interns _and_ her patients."

"Really, my resident wasn't very interested in us. He gave us assignments and we did it. It was as simple as that." Amelia replied. "But you seem to have a better resident." She then answered.

"Amelia …" Meredith tried to stop her.

She wanted to tell her that she doesn't have to do this whole chitchat thing where they get to know each other. But apparently, Amelia didn't want to seem to listen to Meredith's attempts to interrupt her. Meredith noticed that the youngest Shepherd was outspoken but somehow Meredith knew that there was something else beneath the surface. She didn't know what but there was something. "It was crazy. We were five people and only two of us made it. That was me. I know that sounds braggy but I'm telling you this because I think you have good chances of making it too." Meredith sighed before saying: "You don't have to do this. The pretending 'you like me'-thing, you don't have to do this." Amelia stared at her for a few seconds. The first thing that came into her mind was Nancy. Always too harsh and direct and not always fair, especially to those who aren't fitting her agenda …

"Is this about Nancy? Let me guess, it is because of her that you think that we all don't like you?" Amelia looked at her openly, waiting for her to reply.

"I thought you all didn't really like me." Meredith as she and Amelia were sitting on a bench outside the hospital. Each of them had a cup of coffee in their hands. Amelia Shepherd laughed. "You don't have to take Nancy so seriously. She's just …"

"Bitchy?" Meredith offered, knowing herself that she was being unfair. But Amelia didn't seem annoyed. She seemed like she actually enjoyed time with Meredith. "Yeah, that'd fit." She chuckled. "She's really a bitch sometimes, you know but she's also my sister even though she isn't exactly treating me like I am …" She trailed off, staring at the street that was at least hundred meters away. Meredith didn't respond. She knew what it felt to be treated like that, like she was out of place. She figured Amelia didn't really wanna talk about it so she didn't press for further information. Everyone has something to keep a secret.

She had, too. A big one. That she failed to mention when starting her internship at Seattle Grace.

Up until a few months before the whole heart-surgery-thing happened ... but that was the past. Now she wanted to focus on her hopefully bright future with Derek, the love of her life. Hopefully this was it coming from her crappy heart. But you never know do you? So she tries not to remain so hopeful because eventually it'll shatter into a million tiny pieces.

Meredith tried to think about something by diverting her attention back to Amelia who was looking at her, curious.

"Meredith? You okay?"

Meredith looked at her, confusion in her eyes.

"I'm fine."

Then there was a somewhat awkward pause between the both of them and neither of them said anything.

"I'm pretty sure he won't avoid you forever. You have to give him time. I don't the whole story but it'll work out." Meredith assured her. "How can you be sure?" Amelia asked back, gazing at her sister in law.

"I've encountered so much crap in my life and eventually, everything went back to normal. It just needs time. You'll work it out, Amelia. I'm sure of that." Meredith smiled, happy that at least one Shepherd sister seemed to like her. Or was it a trap? No, Meredith doubted that since Amelia didn't seem like the type of girl who does that.

"But what if not?" Amelia said, sounding unsure.

It seems like deep down, Amelia has abandonment issues as well. It seems like Amelia and she have more in common than anticipated. She just needed to make Derek see what his actions do to his family. Because she knew one thing: family was important. And he has a family, not only in Seattle but also on the other side of the country. "You will. Keep the faith. It worked for me, too." Meredith bit her tongue. Maybe she shouldn't have said the last part.

Amelia looked at her in shock.

"What ... happened to you?" She asked, pausing.

_What am I gonna do? I can't tell her to mind her own business. Shit, I'm screwed, so royally screwed._

Meredith felt increased panic coming up in her. Feverishly, she searched for another topic to dodge Amelia's question. Amelia saw what reaction she got when she was asking that question.

Meredith's heart started to beat faster. But that was due to the situation. "It is okay, Meredith. You don't have to answer if you don't want to." Amelia touched her arm in a comforting gesture. "But if you wanna talk, I will be there. I'm a really good listener." She grinned.

"Thanks." Mer said, looking flustered.

"So what do you do?" Meredith started, making conversation.

"I'm gonna be neurosurgeon." She replied with a wide grin. "But it's also a lot of pressure to be as great as Derek already is. Don't get me wrong, I love him even if he treats me like crap. But it's a lot of pressure." Meredith nodded knowingly because she knows what her sister in law is talking about. "Oh, it seems like the footsteps are very big." Meredith noted. "Believe me I know what you're talking about." Amelia frowned. "Your name was Grey, right?" She asked. Meredith nodded. "Grey?" Amelia suddenly said, not directly asking Meredith. "Your mother is Ellis Grey the surgical legend and winner of the Harper Avery twice, right?" She then asked as she finally connected the bits and pieces of information. "Yeah, Ellis Grey is my mother." Meredith confirmed Amelia's assumption.

"And I went to both of those dinners, whole Harper Avery thing."

Meredith chuckled slightly.

"Do you remember any of it?" She then asked, happily engaging in this conversation.

"Uh, I was only four when she won her first Harper Avery. But yeah, I remember the second time. I mean I was eight. I even told Cristina, my person."

"Do you mean Cristina as in Yang? The one that works here at the hospital? I didn't know you knew her before you started your internship." "Well, I'm pretty sure she doesn't remember either. We were like five years old at that time. She moved when we were ten. I haven't seen or heard her since the start of my internship. But Cristina is the best friend I have ever had. She gets me in a way others don't."

"You haven't had it easy." Amelia stated.

"Have you had it easy?" Meredith shook her head. "I'm sorry, I can be insensitive at some times." She apologized to Amelia.

"So can I."

Her brother really had a fantastic taste in women. Meredith was so much cooler than her own sisters and that meant something. She shook her head to try and get that thought out of her head but she was only partially successful.

Amelia nodded shortly before asking: "I wanted to go do some shopping while I'm here. You wanna join me? You're off duty, right?" The neurosurgery fellow asked her. Meredith was surprised that Amelia wanted to get to know her.

Meredith looked at her shocked.

Amelia chuckled to cover up her amazement at Mer's reaction to her suggestion.

She didn't seem like the type of girl who takes no for an answer, more like the "badass" type of girl who doesn't let anything or anyone get in her way. Still completely at a loss of words at Amelia's suggestion, she said yes. "You mean that? You're not just saying that because you want to test me? I never … I have never really done this before, the whole 'meeting the boyfriend's family' and 'acting sisterly'-thing." Meredith rambled nervously. Amelia laughed. "I see. But don't worry. This isn't a test. I'm the last to judge." She then added. "That's where I'm different from my sisters."

"Oh thank god." Meredith murmured.

"No offence but I don't know if I can stand four judge-y sisters of Derek." Amelia glanced at her for a second before attempting to answer her question. "Well, me too, I know what you're talking about." Meredith accepted that as an answer.

Instead, she said: "Let's go."

* * *

A few hours later, both of them have been to a lot of stores and Meredith once again knew why she didn't like shopping at all, especially when doing that in crowded and stuffy spaces like in shopping malls. "Amelia, how long do you think you need?" Meredith asked, hoping that Amelia was able to hear her. "I just have two pieces of clothing to try on." Amelia called back, her voice was sounding muffled through the door. "Do you need me?" Meredith asked, feeling that the heat and the loud music had an impact on her. Her heart was pounding in her chest and she was feeling slightly light-headed, most probably related to the whole situation. "No, I'll be done in, like, ten minutes." She called back while looking at herself in the mirror. "Uh, no, that looks …" She murmured. Meredith inhaled and exhaled deeply.

"I … can you maybe rush a little?" She looked around, for something to sit on.

When she sat down, she reached into her purse. She always had a bottle of water stored in her purse in case she needed it. And right now, she did. After drinking a few sips of water she felt a little better but she still hoped that Amelia would hurry. In that moment, Amelia appeared in front of her, wearing a dress. "What do you think?" Meredith first didn't really respond.

"Meredith, are you listening?" Amelia asked.

"Uh, yeah, I am. What's going on?" Amelia gaped at Meredith, then she frowned, and slowly worry etched over her face. She remembered what happened this morning. Meredith was very nervous when Burke talked to her in front of them.

It was like she was hiding something.

And it might have something to do with what's going on with Meredith now.

"Are you okay?" Meredith looked at her, confusion etched across her face. "I'm …" "Let me guess you are fine?" Amelia responded with an eye roll. Meredith nodded. "I just don't like hot, crowded spaces. It makes me woozy." She explained. "Oh, so that's why you wanted me to hurry up, am I right?" Amelia wanted to know. She knew that this was only half of the truth and that there was more to the story than that what Meredith disclosed.

Meredith nodded.

"Okay, I'll be quick." Amelia excused herself and hastened back into changing cubicle to change into her street clothes. She remembered the paleness plastered on Meredith's face and that had shocked her. Maybe she wasn't the only one who had problems but from the looks of it, it seemed like Meredith's problems were more likely to medical related. When she appeared again, she said: "Ok, then. We can go and find a nice, quiet coffee shop to take a break from all the shopping. What do you say?" Amelia looked at Meredith who nodded. "Sounds fine with me." She then said.

When she got up, she swayed for a second before she steadied herself. For a moment, black spots danced before her eyes. Amelia watched this advertent.

* * *

**A/N: I hope you liked this chapter. **

**It shows how Amelia and Meredith are bonding. Also, Amelia has noticed that there's something not quite right. Stay tuned for the next chapter ... ****So, tomorrow starts school again which means there will be not so much time left for me to update my stories. Nevertheless, I will try and update 'If Tomorrow Never Comes' as soon as possible. **

**Medical notes: The ejection fraction (abreviation: EF) is an important measurement in determining how well the heart is pumping out blood and in diagnosing and tracking heart failure.**

**Please leave a review on your way out. **


	52. Chapter 52

**Chapter 52**

* * *

**Everybody has something to hide. We can't just expose all our secrets to the world. That's how we get hurt. That's how we risk hurting other people. We have to decide how much we let out and keep the truth to ourselves. It's scary to reveal everything about ourselves. Fear makes us hold ourselves back. Is that so wrong? Maybe. Probably. But still. It helps to be a little sneaky, a little protective. It's not safe to just blurt out all of your secrets. We can't just lay all the truth out there. Expose ourselves to God and everybody. 'Cause once the truth is out, we have to face it ourselves.** Meredith Grey; The Great Pretender

* * *

A few hours later, both of them have been to a lot of stores and Meredith once again knew why she didn't like shopping at all, especially when doing that in crowded and stuffy spaces like in shopping malls. "Amelia, how long do you think you need?" Meredith asked, hoping that Amelia was able to hear her. "I just have two pieces of clothing to try on." Amelia called back, her voice was sounding muffled through the door. "Do you need me?" Meredith asked, feeling that the heat and the loud music have had an impact on her. Her heart was pounding in her chest and she was feeling slightly light-headed, most probably related to the whole situation. She was sure it wasn't something medically wrong, especially since she just had the echocardiography and Burke telling her everything was looking good at the moment.

"No, I'll be done in, like, ten minutes." She called back while looking at herself in the mirror. "Uh, no, that looks …" She murmured as she looked at herself. "... bad." Meredith heard her finish the sentence. "Good." Meredith answered loud enough for Amelia to hear. With that she left Amelia by herself, wandering through the shop and looking for something to sit on.

She was so deeply in thoughts that she walked past a bench.

Meredith inhaled and exhaled deeply.

She tried to think of something else. Something that would keep her mind off of it. But she kept thinking about Derek's family and what they would think of her if they _knew_. If they knew what she was hiding from them.

It felt kinda wrong to hide it.

Those defects were a part of her and she's reached acceptance. She accepted that nothing could change that she was born with a cardiac lesion this complex and severe.

"I … can you maybe rush a little?" She looked around, for something to sit on.

When she sat down, she reached into her purse. She always had a bottle of water stored in her purse in case she needed it. And right now, she did. After drinking a few sips of water she felt a little better but she still hoped that Amelia would hurry. In that moment, Amelia appeared in front of her, wearing a dress. "What do you think?" Meredith first didn't really respond.

"Meredith, are you listening?" Amelia asked. Meredith didn't seem like she was.

She probably wasn't.

Amelia Shepherd is correct with her assumption of Meredith not listening to what she says.

"Meredith?" The surgeon repeated her name, hoping to get Meredith's attention. When she said her name for the second time, Meredith turned her head, looking straight at her before finally attempting to answer.

"Uh, yeah, I am. What's going on?"

Amelia gaped at Meredith, then she frowned, and slowly worry etched over her face. She remembered what happened this morning. Meredith was very nervous when Burke talked to her in front of them.

It was like she was hiding something.

And it might have something to do with what's going on with Meredith now.

"Are you okay?"

There. She had asked it. The words had escaped her mouth before she could rethink it. Her question lingered in the air.

Meredith looked at her, confusion etched across her face. "Why are you asking that question? I already have Derek doing this." Amelia gazed at her brother's fiancé. "I'm just asking if you're feeling alright." Amelia backed off slowly. Meredith groaned inwardly. She should be used to this by now. But in reality she wasn't used to everyone fussing around her as if she would break any minute. "I'm …" Meredith attempted to answer but before she had the chance, Amelia cut her off. "Let me guess you are fine?" Amelia responded with an eye roll. Meredith nodded. She was fine. She's now painfully aware that avoiding in her case wouldn't do anything even remotely good. If she does that and something happens she would have to deal with the repercussions, again. Meredith Grey has learned her lesson, painfully learned.

"I just don't like hot, crowded spaces. It makes me woozy." She explained. _Please let this be enough of an answer_, she silently begged. Amelia gazed at her before exhaling deeply.

This made her think like a doctor analyzing a patient's symptoms.

But she decided it could wait.

Meredith desperately hoped there wouldn't be any more questions 'because she didn't think that she could handle the one thousand questions right now. "Oh, so that's why you wanted me to hurry up, am I right?" Amelia wanted to know. She knew that this was only half of the truth and that there was more to the story than that what Meredith disclosed.

Meredith nodded.

Amelia Shepherd looked at her, Meredith knew she was analyzing her, trying to see if there is anything she is not telling.

There was, in fact but that's beside the point.

"Okay, I'll be quick." Amelia excused herself and hastened back into changing cubicle to change into her street clothes. She remembered the paleness plastered on Meredith's face and that had shocked her. Maybe she wasn't the only one who had problems but from the looks of it, it seemed like Meredith's problems were more likely to medical related. From what she's seen, everything points to something medical related. When she appeared again, she said: "Ok, then. We can go and find a nice, quiet coffee shop to take a break from all the shopping. What do you say?" Amelia looked at Meredith who nodded at the mention of food. Now that Amelia mentioned it, she was indeed hungry. "Sounds fine with me." She then said.

When she got up, she swayed for a second before she steadied herself. For a moment, black spots danced before her eyes. Amelia watched this advertent. "Are you okay?" She then asked, watching her. "Yeah, sure. Why wouldn't I be?" She was fine. She just had the cardiac check-up which revealed nothing relevant. Meredith shrugged her shoulders.

"You sure?" Amelia asked, suddenly dead serious. "Yes, I'm positive. I'm okay." Meredith assured her. Worrying was apparently a Shepherd- kind of thing to do. Derek does it, and his youngest sister does it as well.

It was like they had an antenna for those things.

That's why she always avoided to talk about those things. "I just don't do so well in crowded and hot spaces. It's having a more negative effect on me, apparently." She then added.

"You sure this is all?"

Meredith noticed there was music playing in the background.

Amelia looked at her as if she didn't really believe her. "Because somehow I don't believe you."

"I never asked you to believe me." Meredith only replied.

**14:26**

Amelia stayed silent. It was right. But before she could figure out what to say Meredith's phone suddenly went off. The sudden loud noise startled both of them.

"That's my phone. It's probably Derek or Bailey, I guess." Meredith murmured while reaching for it. She figured it wasn't Cristina since she didn't really like talking on the phone. When she had the phone in the hand, the display lit up and when she checked the caller ID she saw it was Derek.

A smile could be seen on her lips when she recognized that it was his name on the display.

She'd kinda hoped it would be him.

"Who is it?" Amelia asked when she heard the noise of the phone that was ringing.

"Derek."

That was Meredith's only answer.

"Don't tell him you're with me." Amelia asked her. Meredith gazed at her, asking for the reason. Amelia replied only reluctantly. "Because sometimes, he can be a real jerk."

Meredith frowned for a slight moment. "I know that. Believe me. Anyways, I going to answer that call." Without waiting for Amelia to reply, Meredith tapped on the button that said 'answer call'. "Hello, this is Meredith Grey." She said. Soon she heard Derek's voice from the other end of the line. "It's me." Derek simply said. "Derek." Meredith said his name. Then she waited for him to start talking. "So, where are you? It's just that I have gotten your lab results and nobody knows where you are right now. But I did meet Bailey and she told me that she gave you the day off." He then questioned. Meredith looked over at Amelia. She wildly shook her head to signal Meredith that she shouldn't say anything to Derek.

"I'm, uh, at the mall." She finally answered. "Bailey gave me the day off. She says I have to do the bonding thing."

Meredith chuckled.

She could feel that Derek was smiling.

"The bonding thing?" Now he sounded curious. "You know the thing I where spend time with your family without you babysitting me." Meredith explained, mentally cursing herself since that sounded somewhat weird.

Derek knit his brows in confusion.

"Well, I know for sure you're not with my mother because she's standing right here. Nancy? Highly unlikely unless she had a sudden change of mind which I honestly don't believe since she's particularly difficult and stubborn when it comes to those things." Meredith desperately tried to think of something that would distract him from the topic. Amelia hoped she wouldn't blab anything about her spending time with Meredith. She didn't need Derek yelling at her for that as well.

"So it's either Liz or Amy." He concluded.

_Damn it. _Meredith thought. _He really was good at concluding those things._

She didn't want Amelia to be mad at her either. If Derek finds out, he'll be mad too but he will also calm down soonish.

Meredith knows that.

"Mer, you're still here?" He asked into the phone. "Yes, of course I'm here."

"You weren't answering." He replied, she heard him breathe in deeply on the other end.

"You asked a question?! I'm sorry I didn't listen." Meredith replied, exchanging glances with Amelia who was impatiently waiting for her to end the call. "Now I do." She then added. "So I'm curious which one of my sisters is currently with you?" He questioned, laughing. Meredith gazed curtly at Amelia who shook her head wildly, signaling her that she did not want Derek to know that she was with Meredith.

"You said something about my lab results?" Meredith asked, avoiding the topic.

Obviously.

"Yes, I did." Derek paused. "Why?"

Meredith waited a few seconds before replying. "Have you opened them?" She then asked softly, needing to know. "No, I didn't." The famous neurosurgeon then answered. "Why wouldn't you open the envelope?" Meredith wanted to know. Derek said softly: "I figured you'd want your privacy with those things and I respect that."

"I don't mind. I would have told you anyways." Meredith replied.

"You sure?"

"I am. Why wouldn't I be?" Meredith asked back. Derek didn't reply but that was okay. He didn't have to anyways. Through the line she heard him open it. She guessed that he was probably reading them over. "Derek." Meredith said his name, nervous. Derek read over the results, seeing instantly that there was nothing abnormal. "Everything looks good." He then said, knowing that Meredith would calm down after that. "Really? You're not sugarcoating anything, are you?" Meredith asked, wanting to know the truth. What she didn't know was that _this _right here was the truth and nothing else.

"So that's good." Meredith said.

"It is." Derek confirmed. In this moment, Derek heard his pager go off. "Mer, I have to go. One of my post-op patients has deteriorated." He then explained quickly.

Meredith sighed because that meant that he really had to get back to work which means he won't be able to talk to her over the phone any longer.

"I gotta go, love you." Derek simply said, in a more rushed voice.

"Love you too." Meredith said before Derek ended the call.

* * *

**15:05**

"So what is it?" Amelia asked her bluntly. Meredith looked up but didn't reply. "You don't want to talk about it." She said after a few minutes, or what seemed as if it were minutes. "No, I do not want to talk about it. If I wanted to talk about my problem or not-problem, I would have done it already." Meredith hissed, slightly annoyed. "Fine." Amelia decided to let it go for the moment. "I will shut up now." For a few minutes, they sat in silence before Meredith interrupted the partly awkward silence between them: "I know we already talked about this but ..."

"'bout what?" Amelia asked after finishing with chewing. Meredith glanced aside for a slight moment.

"About Derek's and your sisters." Meredith finally said.

Amelia looked aside.

She didn't ... she was more like the black sheep of her family, a disappointment, Amy the screw-up-she was sure that's what people saw in her.

"Why are you specializing in neuro? I mean there are other specialties without that much pressure. I don't think I'm going to do general surgery since neuro is much more interesting. But why did you choose neuro as a specialty?" Meredith asked. Surgery was a safe topic. That they could talk about without having to fear that someone didn't like a specific topic.

"Well, neuro was the most interesting rotation I had. I spent most of my residency in neuro and then some. Cardio wasn't really my thing, pediatrics was to intense and ... well, I guess it was a calling or something." Amelia shrugged. She had no idea how to explain it any better.

"I don't have a husband, nor do I have kids. I have my neuro fellowship, and that's it."

"Well, at least you're fellow and not an intern." Meredith said.

"Aren't you a second year now?" Amelia asked, she eyed Meredith for a moment. "Why are you staring at me?" Amelia flinched.

"No reason." She quickly answered.

"Well, my sister, Lizzie -she's the pediatrician- says it's always hard when the diagnosed condition is difficult to manage. She told me last week about one of her patients. A patient living with single ventricle anatomy."

Meredith gasped at the mention of this.

Amelia paused, her gaze went over to Meredith who seemed to have reacted to what she just said.

"You know what that is?"

She was met with silence. After a few seconds, a stunned Meredith nodded.

"A really sweet girl, about three now and about to undergo a Fontan completion, the last stage of a series of ..." "... three operations." Meredith interrupted. "I know." She fell silent again. Soon her gaze diverted to her plate, she was intentionally avoiding looking at Amelia.

"How?"

"Why are we even talking about her patients? I mean your family, I'm pretty sure they all have kids and husbands and perfect houses ..." Meredith rambled. Amelia didn't know what to reply. Soon she knew that Meredith had no to little idea what to expect. "You don't ... you've never done the whole family thing, have you?" She then realized.

"No I haven't. I'm new to this kind of thing. So, please help me out."

"But how did you know about the Fontan procedure?" Amelia asked again.

"How I knew that? I'm a second year resident. I once scrubbed in on a Fontan procedure. Cristina was jealous that it wasn't her on that case, 'cause she's determined to be a hardcore cardiothoracic surgeon."

"That sounds like she knows what she wants." Amelia noted. "What about you?"

"What about me?" Meredith asked back.

"Do you have a specialty of preference?" The neurosurgeon fellow asked her. "Well, I love neuro, obviously. And no, it's definitely not because Derek. I know what you think, it's what anybody would think who didn't know me. But I'm not interested in neurosurgery because Derek is. It's just that the brain's an interesting organ. And well ... I ... I mean I know there are other interesting and exciting specialties, for instance pediatric surgery or cardiothoracics. But I can't imagine dealing with patients who have that kind of problem every day. Also it's always harder with children." She then added.

Amelia listened to her closely. "But you're right, neuro really is satisfying and exciting. Cutting into brains gives me a rush, you know. As if nothing in the world could harm you."

Meredith smiled.

"That's the way I feel every time I'm in OR, regardless of which specialty."

Then they were back to eating in complete silence. Nobody was confident enough to break the silence. After some time, Meredith giggled quietly. "What are you doing?!" Amelia asked surprised. "No, it's just we're sitting here in silence and eat but nobody says anything. I mean that's kinda awkward isn't it?" She asked a rhetorical question.

"Yeah." Amelia smiled softly. "I guess it is. Kinda."

After they both finished their meal, Meredith glanced at the time her mobile showed and said: "Maybe it would be better if we were on our way back to the hospital."

Amelia looked over to her before asking a question. "Why? Do you have a pressing issue that can't wait?" Amelia questioned her. Meredith sighed. She didn't want to explain why she didn't want to spent any more than necessary in a shopping mall.

No, she didn't. But shopping was exhausting, the noises, the lights.

**15:49**

"Fine, we'll go back to the hospital." Amelia relented. So they were making their way back to the exit.

Then they both got distracted by a woman and her son.

"Leon, I already told you not to do that." She explained to the little boy, but keeping her voice low. The boy looked like was hearing but not actually listening to his mother says. "I still need to ..." She said while looking at her shopping list and was checking the boxes off innerly. In that moment, there was loud announcement over loud speaker, announcing there is some kind of event happening in this shopping mall.

Soon, a crowd of people was walking through this aisle. They were chattering loudly. "So, let's go. You need clothes. You've outgrown most of them." Leon didn't seem to listen. He was fidgeting on his shirt.

"Leon, are you listening to me?" The mother asked, trying to get her child's attention but failed.

In this moment, the boy's "_fight or flight_" response kicked in and he started running away. "Leon, stop!" She called after him and she started chasing after him. She knew why he was reacting this way. It hasn't been the first time for him to react like this. He usually gets like this if something overwhelms him and it just gets too much. It happens in children with attention deficit/ hyperactivity disorder, and in children with sensory processing issues. This is how a sensory meltdown works.

This is sensory input that floods his brain. That excess input overflows in the form of yelling, crying, lashing out or running away. In his case, running away. Fleeing. But before the mother was able to reach him he tripped over something.

It seemingly came out of nowhere.

"Watch out." Someone called, a little shocked about the sudden commotion as he jumped aside, out of the boy's way. The boy didn't see that. Instead, he kept on running, as if he didn't hear his mother shouting his name and the other people looking at him. But it was too late.

It already happened.

The boy tripped. For a moment it looked like the boy would be able to keep his balance and keep running but after another few seconds, Meredith saw that that wouldn't be the case. And then, the boy lost balance and hit the ground.

"Leon?!" The mother screeched in panic as she saw what happened.

When she reached him she kneeled down next to him and called his name, hoping he'd respond. But from the looks of it he didn't respond at all. That didn't look too good.

Meredith let her fork fall onto the plate and got from her chair.

Meredith and Amelia exchanged a quick glance before they both abandoned their food to offer their help. "Did you see that?" Amelia asked as she turned to her. It was a superfluous question when considering that Meredith has seen what happened. Meredith looked at her soon to be-sister in law before saying. "Let's go see if they need help." Meredith gave back determined and they both walked over to them.

"Do you need help?" Amelia asked professionally. "We're doctors at Seattle Grace Hospital. Well, she is. I work at another hospital but I guess that's irrelevant right now."

"That would be great."

The woman didn't seem like she has heard anything besides the fact that they're both medical professionals. It seemed like they got lucky in some weird way.

The boy whimpered suddenly. "... hurts."

"What hurts?" His mother asked concerned. "Head ... ow." Meredith and Amelia shared a concerned glance.

Meredith shared a glance with Derek's sister. They silently agreed on what to do. Meredith then turned to those who were standing there, watching.

"Any of you got a phone?" She then asked shortly.

First, no one of those who were standing there said anything. Meredith stared at them in disbelief and then searched for her own phone in her handbag. Then she dialed 911, soon she was on the phone with emergency dispatch. The young doctor quickly told them what they needed to know and then after finishing the call, she helped Amelia who was assessing the boy's injuries and neuro status. After the ambulance was there, Meredith told them to bring him to Seattle Grace.

* * *

**16:35**

"I'll page pastics." Meredith said. "He can take a look at this. It won't take very long, hopefully." She smiled at them. "You manage this, Grey, ok?" Amelia told her. "Page me if there are any changes that point toward head injury. I have something to do." She then excused herself.

Meredith only answered "Absolutely, not a problem." before she started taking the boy's medical history and asked if there was anything else that was hurting.

But the answer was no. She reevaluated the kid's neuro status but was pleased by his responses since they were perfectly normal. But he was a little groggy so she did opt for a head CT just as precaution.

* * *

**17:12**

Around thirty or forty minutes later: "Somebody paged me?" That was Mark Sloan's voice. Meredith leaned against the counter of the nurses' station and scribbled something onto a patient chart. When she heard Mark's voice the first thing she got out was: "Finally." When the plastic surgeon heard her he turned to her and chuckled lightly. "So you paged me?" Was his question. Meredith glanced at the plastic surgeon before attempting to answer.

"I did. Thirty minutes ago. Where were you?"

"According to Dr. Bailey you were supposed to not be at work, Grey." Mark frowned.

"Come on, Mark. She won't even know that I was here once I figured this case out. You won't tell Bailey. We dirty mistresses gotta stick together." Meredith knew that this would get Mark to agree.

It was his thing after all.

"Oh you so got me, Grey." Mark laughed before getting serious again. "Why don't you tell me what happened?" Meredith looked over his shoulder, trying to see whether there was something coming - someone as in Bailey who won't be very happy to see Meredith no listening to her instructions.

"Yeah, well I wasn't at work up until this thing happened." Meredith kept the story short.

"This thing?"

Mark Sloan looked at her, not exactly understanding what she meant. She knew that by just looking at him. "I don't get what you mean." He said. "Care to elaborate?"

"This thing, the thing I paged you for. That is the reason." Meredith was quick to explain why she was at the hospital. But there wasn't much she was actually telling.

"Well, I was with Amelia at the mall ..." The young doctor tried to explain but got cut off by Mark.

"You were with one of Derek's sisters?" He grinned like stupid. Men and their stupidity. "Not so loud, Mark. They are gonna gossip which is what I don't like about this hospital. Just because they don't have things they wanna keep secret ... not all of us want to be top ranking topic in the nurses' gossiping thingie."

"Okay, did you really just say words hoping they'd make sense somehow?" Mark asked, smirking his usual McSteamy grin. "Uh, kinda." Meredith retorted.

"I see." Mark nodded.

"Well, then there was this boy who fell and hit his head and I now I need you to check out that wound, got that?"

"On my way." Mark Sloan said as Meredith followed him over to curtain three.

After he was done checking out the wound he turned to Meredith: "You can stitch that up. It's only superficial but maybe you should get a head CT to check for concussion." He said. "Yep, I already informed CT. They will let me know as soon as they have space." Meredith explained to him. "Good, clean this and stitch it." Mark said before shaking the mother's hands. "It was nice meeting you, Mrs Petersen."

**10 minutes later**

After a few minutes, Meredith was done cleaning and stitching up the wound. "So, I've stitched the wound." Meredith explained as she discarded the used materials in the medical waste bin.

"So he'll be okay?" The mother asked concerned. "We'll do a head CT, just as a precaution. We don't think there's anything that might indicate that there is something wrong with his head. So let's not worry until we have to." Suddenly, Amelia was back.

"So the CT's just a precaution? Nothing else, there is no deeper reason that leads you to believe there's …"

Meredith shook her head.

"If the head CT comes back clean, he is free to go home. But remember, he should take it easy for the next few days. I'll let you know as soon as they're ready for us." Meredith told them. The mother who was beyond worried, thanked her quietly. "I will come and talk to you as soon as we get the results of the head scan." Amelia just watched her interact with the patient and the patient's mother. She didn't have to do anything at all because Meredith did it all on her own.

"Ok, then. See you later."

**17:22**

Meredith was waiting for the scans of the boy's brain to pop on the computer screen when Derek entered the room.

"Hey, you're back. I thought you had the day off? Why are you spending your day off at the hospital?" He asked after pressing a short but loving kiss on her forehead. Meredith turned to look at him. "I spent the day with Amelia, Derek. We were at the mall." She revealed. Derek stared at her, flabbergasted.

"Say something." Meredith urged him as she saw his perplexed face.

"This ... is just surprising."

"Because I'm me?" Meredith said laughing.

"Because you're you." Derek replied, a smirk covered his face. "But you know I love you and everything that makes you, you." He flashed his dreamy smile he only reserved for her. Meredith sighed before saying: "You should talk to her, Derek. You do this to her forever. She really wants you back."

"Meredith." Derek said, surprised about the sudden change of topic.

Meredith is usually the one who's always for avoiding. She prefers avoiding over talking about problems or anything for that matter.

The 'intern' saw the surprise in Derek's eyes.

She smirked lightly.

"How …" He stammered, taken by surprise.

"She is your sister, Derek. You should buy her a cup of coffee, talk it out. It's pretty clear that you have something to talk about. Even I see that and you know me. I am usually the one who is all for avoiding, but in this case I'm not. She's your sister which soon makes her my sister in law. Also, I love you, Derek and I can see that it's not doing you any good." Meredith tried to talk to him about his current situation with his youngest sister.

"It's none of your concern." Derek grumbled at her.

Meredith scoffed. "It is my concern because clearly it bothers you and you are my family. I don't leave my family alone. Also, Amelia's the only one who's actually nice to me. She's treating me like I am a human being, what I can't exactly say about your other sisters, Derek. C'mon, whatever the history it doesn't matter, there are way more important things. What if she has an accident, Derek, and dies? You won't be able to make things right with her and it's gonna follow you the rest of your life."

Derek didn't seem like he was listening to her.

He made that really clear.

Meredith tried to get him to see on what he was missing out and what a giant mistake he made by acting the way he was acting. "If I bought every one of them coffee, we wouldn't have anything." He told her stubbornly. Meredith groaned suppressed. Derek could be an asshole sometimes. He really could.

It was like he didn't hear the last sentence.

"Derek." Meredith exclaimed. Now she was partially annoyed at Derek's behavior.

"Have you even taken the courtesy of listening to me?" Meredith held him back so that he was now looking at her without having the choice of leaving.

"Why don't you go spend a day with Amy? She's a laugh a minute." With that he turned to leave. She already did spend a day with Amelia. Why didn't he remember that? Meredith shook her head, slightly irritated. "Derek Shepherd. You are so not doing this." Meredith said loudly. This was inacceptable. Derek started walking away when she let go of him.

Meredith couldn't believe that he was really doing this.

"Meredith, please just leave me alone. This has nothing to do with you. Just please leave me alone." With that he left. Derek knew it was wrong what he was doing but he just couldn't face Amelia. He couldn't do it, he just couldn't. Not after what she did to herself, to him and to his family and most importantly, to their mother after losing her husband and their father. Meredith didn't know all of what happened, only parts. Meredith leaned against the cold and hard wall and closed her eyes. This whole Shepherd family thing was more difficult than she thought. Especially with Amelia and Derek on each other's throats … Meredith shook her head and walked away. Derek left in the opposite direction.

He didn't want to see it but Meredith did have a point. But he didn't have much time to think before his pager beeped loudly.

He grabbed the pager to look at the screen. ER 911_._

He was paged to the Emergency department. This was going to be a long day.

That was for sure.

When Meredith stared back at the computer screen she didn't notice Bailey who had seen her. "Grey. What did I tell you? What are you doing here?" Meredith turned around shocked. She didn't think or well, hoped that Bailey would see her.

Apparently, she'd been wrong this time.

"So you wanna tell me what this is about?" She asked with a raised eyebrow and a view that was shooting daggers at the young surgeon who just wanted to disappear completely. "Because I remember telling you to take this day and spend it anywhere but the hospital which brings up the question: what are you doing here?"

At first, Meredith had no idea what to idea. She didn't intend on getting busted by her superior. One that she respected.

Oh dang it, that was not the way she'd imagined this.

* * *

**A/N: Thank you for reading. So I promised myself to update this story before the new year starts.  
**

**Attention deficit-hyperacttivity disorder is a brain-based condition that interferes with a person's ability to stay on a task and executive functioning issues, which can impact working memory, inability to organize and planning, and the ability to start tasks and leaving projects, chores and homework unfinished. It can cause inattention, impulsivity and hyperactivity. Children having this disorder may also have trouble paying attention to and responding to details. There are several types of ADHD: a predominantly inattentive subtype, a predominantly hyperactive-impulsive subtype, and a combined subtype. It is usually diagnosed in childhood. The usual course of treatment may include medications such as methylphenidate or dextroamphetamine, which are stimulants that decrease impulsivity and hyperactivity and increase attention. Treatment should include structured classroom management, and tutoring and/or behavioral therapy for the child. A person who has the inattentive type is often described as "daydreamy" because hyperactivity and impulsivity are missing. This type often goes undiagnosed or is late diagnosed because the child is quiet and not disrupting anything. ****A lot of peope know about the common type with hyperactivity but not about the predominantly inattentive type.  
**

**I know I still haven't updated 'What If Tomorrow Never Comes'. So, what I'm trying to say is that I'm not sure when I'll be updating that story and this one (too) again.**

**I wish you all a happy new year's eve and a good start into the year 2016 ...**

**Hope you review.**


	53. Chapter 53

**Chapter 53**

* * *

**A surgical residency is all about training for the worst. But, as prepared as we might be, we usually don't see disaster coming. We can try to envision the worst-case scenario, to foresee catastrophe. But, when true disaster strikes, it often comes out of nowhere. And when the worst really does happen, we find ourselves completely blindsided. Why do bad things happen to good people? We ask that question so often, it's become a cliché, but that's because bad things do happen to good people constantly. You just have to hope that when it's your turn, you'll know what to do, how to cope, how to persevere. But the truth is, you don't know how you'll react to your worst-case scenario. None of us do. Not until it happens. **Meredith Grey; One Flight Down

* * *

When he reached the pit, they were already waiting for him. Shit. He'd hoped to be there before the patient arrived. He walked over to a nurse, wanting her to tell him where he was needed and what for the paged him. "Dr. Shepherd, there you are. We've been waiting for you." The nurse said, her voice was a little bit distressed. Derek threw her a glance before asking: "Now where's the patient you paged me for?" He wanted to know, while looking around, searching for someone who needed a neuro consult. "The patient is over there. Trauma 4." The nurse said and led him over to the patient. "What kind of injuries are we dealing with?" He wanted to gather as much information as possible.

"37-year old male, MVC, possible head and abdominal injuries. He was unconscious en route but regained consciousness after a while." An EMT told him as he entered the trauma room.

"I'll take it from here." Derek said, before turning his attention to the patient. Derek turned to look at the patient. He was very surprised when he found out that he knew who this was.

Derek gasped in response. His gasp got the patient's attention who looked up. He seemed confused at first before he recognized him as well. "Mike?" He asked, not exactly believing what he saw. "What are you doing here?" He questioned despite seeing _why _he was here.

The motor vehicle crash was the reason.

The guy on the bed looked up and a surprised face expression could be seen as he recognized his friend from college. "I'm here on a family trip. But then this happened." He motioned to his head. Derek immediately saw the problem. "How did that happen?" He then questioned politely. "Somehow my wife lost control of the car and that's how we ended up here. I don't know about her. Could you maybe find out about her and my two kids? I've been told they were taken to get some kinds of tests done?" He then asked.

"Sure, I'll see what I can do." Derek said, as he opened the patient chart said that they wanted to do an abdominal CT scan as well since he's complained of abdominal tenderness. "You need to tell me if you are feeling pain someplace else, ok?" He added in a super serious tone that made it clear that he wasn't joking _at all_.

"Beside pain here …" He points to his head and then to his abdomen, "and here, then no, no pain."

"You sure about that?" Derek's ice blue eyes gazed at him intently.

After he did the necessary neuro checks he phoned radiology to let them know that he was on his way down now. Luckily, there was no one using the CT right now. "So, let's get you a head CT and an abdominal CT to make sure there's nothing to be concerned of." Derek told him in a calm and collected voice.

"You said you'd find out about my family. I want my family to be taken care of first. Then you can do whatever tests you want to on me."

Derek sighed. "Mike, come on, be reasonable. Internal bleeding in the head and/ or the abdomen could potentially kill you. I'm not telling you this because it's fun, I do this because you need to acknowledge the importance of this. I'm your doctor and I recommend that CT." He tried for another time but nothing.

"Yeah, after I get to know about my wife and my kids." Derek's friend from college kept on insisting about needing to find about his wife and kids. Somehow Derek understood that. He would do the same with the situation was reversed. "What are their names?" Derek asked softly, taking the time. He knew he wouldn't come through to him in another way. Mike looked up and saw the genuine interest in Derek's eyes: "My wife's name is Marla and my kids' names are Jamie and Kayla, both nine years old."

"Twins?" Derek's eyes lit up when he heard this.

"Yeah." He smiled when he thought of them. Derek put a comforting hand on his arm for some seconds. "I'll find out about them, I promise. After the scans I'll tell you. But please Mike, let me do those scans." Derek begged him as he checked something in the chart, turning his back to him. The neurosurgeon was glad that he was stable for now. But he also knew that that could change quickly and suddenly. That's why he wanted to do the scans

"Why are you so invested in wanting me to have those scans?"

Mike looked at him expectantly. Derek turned around. "Because I've seen what happened to someone I love who didn't listen until it was too late. They were able to save her but … It's better to do it this way, believe me." Derek told him.

"Who are you talking about?" There was that question.

Maybe he'd sensed something.

"You'll probably meet her during your stay at this hospital." Derek didn't disclose any further information. "Dr. Shepherd, I'm your intern for the day." He turned around only to face a blonde woman glaring at him. "Schedule him for a CT and page me with the results." When Stevens didn't move he raised his voice.

"Now. I need to do something." He told her.

"Fine, relax." Izzie told him.

"I'll do it." The patient looked from the intern to Derek and mouthed: "What's this all about?" Derek just shook his head before saying: "I'll check on them for you, Dr. Stevens will take you to get your CT scan and then I'll go over the results with you."

* * *

Meredith was still fuming about Derek's stubbornness as she heard someone calling her name. "Mer, wait." She reacted with: "Not now." The footsteps were getting faster, and then she heard someone saying: "Meredith, it's me, Cristina. Why are you reacting like that?" She heard the person ask. That was Cristina. Oops, she thought. Meredith turned around. Alex was there as well. "Derek's being a McAss."

"To you?" Cristina asked, as Meredith finally turned around.

"No, to his sister." Meredith replied.

"You hang out with his sisters aka the wolves?" Cristina exclaimed. "I did spend some time with his youngest sister. She's not judge-y."

"How do you know?" Cristina stated bluntly, as always.

"Cristina." Meredith looked at her disapprovingly. "Sorry, Mer. I just get bitchy sometimes." "I know. Let me guess, you missed out on a very big surgery and now that is ruining your mood?" Cristina just grumbled something she didn't quite understand.

"What's up with you two?" Meredith asked as she glanced at them. "Bailey's on the warpath. We are doing sutures in the pit." "What have you done to deserve that?" Meredith laughed. "We kinda didn't exactly do what she wanted us to do which led to her catching us in the tunnels doing anything except that specific thing that she wanted us to do." Cristina replied to her person's questions. "Now we're treating patients in the pit, hopefully there will be a nice surgical patient coming in soon."

"Cristina." Meredith exclaimed, looking at the soon-to-be resident, shocked.

"What?" Cristina asked back bluntly. She shrugged. Meredith only shook her head. This was so Cristina. She had no idea why Meredith reacted that way. "I mean it's way better to spend a day in surgery and learning something that will actually help me with my career instead of patching up idiots in the pit that don't have the balls to get real injuries."

"But still that's better than watching mopey Derek moping over his sister." Meredith bluntly said. "Don't ask. You don't wanna know. But I think I was wrong." Meredith spilled part of her secrets.

"His sisters don't hate you?" Cristina said straightforward.

Normally she liked Cristina's straightforwardness but sometimes, it annoyed her. Like it did now. But she was allowed to ask that question, after all she was her person.

"They do." Meredith said. "Well, Nancy does. I don't know about the rest. At least not really. I think they are warming up to the thought that their little brother divorced the perfect wife with the long and perfect legs."

Cristina held back laughter.

"You should hear yourself, Meredith. This was so downright funny." She chuckled suppressed as she watched Meredith's face expression. "What was funny about what I said?" Meredith frowned, not realizing that the way she said it was the cause of Cristina's strangely strange behavior.

"So much for that." Cristina muttered under her breath.

"Not all of them hate me. Amelia, I think, kind of likes me." Cristina looked at her.

"That makes one so far, three to go." She said bluntly.

Meredith huffed.

"And Nancy sounds like she's a real hard piece of work. I am really glad not to be in your shoes." She was still referring to McDreamy-family situation. "You're a big help, Cristina." Meredith gave back. "Hey, I'm just stating my opinion." Cristina answered.

"Apparently."

"What are you doing?" Cristina then asked, poking Meredith's arm with her finger.

"Uh, nothing." Meredith quickly answered.

"You're so lying, Meredith. You can bet your ass that I can tell when you are lying and right now you are." Cristina looked at her waiting for a decent answer.

"Fine." Meredith gave in.

"Well, Bailey kinda gave me the day off because of the McFamily and you know what's funny?" Meredith asked her, but only rhetorically. Both of them knew it.

"Do tell." Cristina's eyes lit up.


End file.
